Provider Demographics
NPI:1902898711
Name:COLUMBINE DERMATOLOGY PC
Entity type:Organization
Organization Name:COLUMBINE DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:BARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-404-0200
Mailing Address - Street 1:10359 FEDERAL BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-7452
Mailing Address - Country:US
Mailing Address - Phone:303-404-0200
Mailing Address - Fax:303-404-2828
Practice Address - Street 1:10359 FEDERAL BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80260-7452
Practice Address - Country:US
Practice Address - Phone:303-404-0200
Practice Address - Fax:303-404-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1848901207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODC7736OtherRAILROAD MEDICARE
CO04019881Medicaid
COCM6708Medicare PIN