Organization
LIVENEW, CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA WILLIAM LONG MD (AUTHORIZED OFFICIAL)
(303) 269-4370
Entity
Organization
Contact information
Practice address
9800 MT PYRAMID CT STE 300, ENGLEWOOD, CO 80112-2667
(303) 269-4370
(303) 269-4371
Mailing address
9695 S YOSEMITE ST STE 285, LONE TREE, CO 80124-2890
(303) 269-4370
(303) 269-4371
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
208600000X
Surgery Physician
DR.0051485
CO
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR.0051485
STATE LICENSE
CO
Enumeration date
06/23/2017
Last updated
03/12/2021
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