Provider Demographics
NPI:1316046303
Name:COTGAGEORGE, JAMES EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:COTGAGEORGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:J. EDWARD
Other - Middle Name:
Other - Last Name:DELLE-COTGAGEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7780 S BROADWAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2648
Mailing Address - Country:US
Mailing Address - Phone:303-730-4400
Mailing Address - Fax:303-730-4401
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-730-4400
Practice Address - Fax:303-730-4401
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0001831103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07018310Medicaid
CO07018310Medicaid
CO434800ZG43Medicare PIN