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Individual

DR. TARA BROOKE KELLEY GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1721 E 19TH AVE STE 300, DENVER, CO 80218-1258
(720) 754-4800
(720) 754-4801
Mailing address
4900 S MONACO ST, SUITE 210, DENVER, CO 80237-3486
(720) 754-4800
(720) 754-4801

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
47002
CO
207RH0003X
Hematology & Oncology Physician
77380
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025893500
NE
05
10939059
NM
05
1407973993
NE
05
1407973993
WY
05
200643000B
KS
05
35029765
CO
Enumeration date
03/22/2007
Last updated
10/21/2019
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