Individual
KIRK T QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 PRAIRIE CENTER PKWY, BRIGHTON, CO 80601-4006
(303) 458-1600
Mailing address
550 S WADSWORTH BLVD, SUITE 410, LAKEWOOD, CO 80226-3111
(303) 202-1283
(303) 202-1281
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
26543
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01265438
—
CO
01
—
930098610
RR MEDICARE
CO
Enumeration date
02/06/2006
Last updated
01/04/2013
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