Provider Demographics
NPI:1154398899
Name:PROCHAZKA, ALLAN V (MD, MSC)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:V
Last Name:PROCHAZKA
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Gender:M
Credentials:MD, MSC
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Mailing Address - Street 1:1055 CLERMONT ST
Mailing Address - Street 2:DENVER VA MEDICAL CENTER, AMBULATORY CARE 11B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3808
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:303-393-4670
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:DENVER VA MEDICAL CENTER, AMBULATORY CARE 11B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-393-4670
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO23649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine