Provider Demographics
NPI:1679640080
Name:PATT, RICHARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:PATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1421 S POTOMAC ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4535
Mailing Address - Country:US
Mailing Address - Phone:303-750-1920
Mailing Address - Fax:303-750-0483
Practice Address - Street 1:1421 S POTOMAC ST
Practice Address - Street 2:SUITE 320
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4535
Practice Address - Country:US
Practice Address - Phone:303-750-1920
Practice Address - Fax:303-750-0483
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO19036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01190362Medicaid
CO01190362Medicaid
COD23542Medicare UPIN