Individual
LORI PROK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
43918
CO
207NP0225X
Pediatric Dermatology Physician
Primary
DR.0043918
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98738569
—
CO
Enumeration date
01/26/2007
Last updated
11/07/2018
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