Provider Demographics
NPI:1366416927
Name:BESCH, NICHOLAS JOHN JR (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JOHN
Last Name:BESCH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 KIPLING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3923
Mailing Address - Country:US
Mailing Address - Phone:303-425-0500
Mailing Address - Fax:303-425-1009
Practice Address - Street 1:7950 KIPLING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3923
Practice Address - Country:US
Practice Address - Phone:303-425-0500
Practice Address - Fax:303-425-1009
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17417207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01174176Medicaid
COC462328Medicare PIN
D23266Medicare UPIN