Provider Demographics
NPI:1104977826
Name:MEYER, JAMES R (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MEYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:10205 TALL OAKS ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7733
Mailing Address - Country:US
Mailing Address - Phone:720-545-8609
Mailing Address - Fax:303-377-2093
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:STE 204
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5411
Practice Address - Country:US
Practice Address - Phone:303-639-9337
Practice Address - Fax:303-639-3244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1072103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63151Medicare ID - Type Unspecified