Provider Demographics
NPI:1588987648
Name:STEVEN J. AYRES, MD, LLC
Entity type:Organization
Organization Name:STEVEN J. AYRES, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:AYRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-761-0234
Mailing Address - Street 1:1741 CRESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-1516
Mailing Address - Country:US
Mailing Address - Phone:303-761-0234
Mailing Address - Fax:
Practice Address - Street 1:1741 CRESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80121-1516
Practice Address - Country:US
Practice Address - Phone:303-761-0234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22979207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01229798Medicaid
CO01229798Medicaid