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Individual

GEORGE STARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2594 TRAILRIDGE DR E, LAFAYETTE, CO 80026-3186
(303) 449-7740
Mailing address
2594 TRAILRIDGE DR E, LAFAYETTE, CO 80026-3186
(303) 449-7740

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
28666
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01286665
CO
Enumeration date
08/24/2006
Last updated
07/08/2007
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