Individual
FERDINAND JESUS LIOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1450 E VALLEY RD, SUITE 201, BASALT, CO 81621-8304
(970) 927-8611
(970) 927-8633
Mailing address
1450 E VALLEY RD, SUITE 201, BASALT, CO 81621-8304
(970) 927-8611
(970) 927-8633
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35451
CO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
35451
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1354513
—
CO
Enumeration date
04/12/2006
Last updated
03/06/2012
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