Organization
BURN AND RECONSTRUCTIVE CENTERS OF COLORADO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN FAGAN (OWNER/MD)
(706) 863-9595
Entity
Organization
Contact information
Practice address
601 E HAMPDEN AVE STE 310, ENGLEWOOD, CO 80113-2769
(706) 863-9595
(706) 447-7179
Mailing address
PO BOX 12330, AUGUSTA, GA 30914-2330
(706) 863-9595
(706) 447-7179
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
04/01/2015
Last updated
10/11/2022
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