Provider Demographics
NPI:1710474952
Name:BACKLUND, IAN ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:ALEXANDER
Last Name:BACKLUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1215 LEE ST # 801016
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-243-0270
Mailing Address - Fax:434-243-0290
Practice Address - Street 1:660 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4506
Practice Address - Country:US
Practice Address - Phone:303-436-4949
Practice Address - Fax:303-602-4560
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2024-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA1710474952207X00000X
CODR.0070122207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery