Provider Demographics
NPI:1174572515
Name:DUVALL, JOHN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:DUVALL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7950 KIPLING ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3923
Mailing Address - Country:US
Mailing Address - Phone:303-422-2305
Mailing Address - Fax:303-422-8605
Practice Address - Street 1:7950 KIPLING STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005
Practice Address - Country:US
Practice Address - Phone:303-422-2305
Practice Address - Fax:303-422-8605
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2007-10-19
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Provider Licenses
StateLicense IDTaxonomies
CO30267207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01302678Medicaid
CO01302678Medicaid
C27321Medicare ID - Type Unspecified