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Individual

JAMES DAVID INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1056 E 19TH AVE, B125, DENVER, CO 80218-1007
(303) 761-9190
(303) 761-6322
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
(303) 493-7202

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
30752
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01307529
CO
05
100035760A
OK
05
100156090C
KS
05
104686211
MI
05
109589700
WY
05
1316987936
MT
05
1546838
IA
05
169996901
TX
05
343658
AZ
05
53820860
NM
05
805063700
ID
01
P00123281
RR MIC MEDICARE
CO
01
P00124424
RR DIA MEDICARE
CO
01
P00124425
RR RIA MEDICARE
CO
05
XPY204028
CA
Enumeration date
06/08/2006
Last updated
10/10/2012
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