Provider Demographics
NPI:1679740914
Name:DORN, PAIGE LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:LEIGH
Last Name:DORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-320-7006
Mailing Address - Fax:303-320-7085
Practice Address - Street 1:4700 HALE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4054
Practice Address - Country:US
Practice Address - Phone:303-320-7006
Practice Address - Fax:303-320-7085
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-052755.2085R0001X
CO579502085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04605811Medicaid