Provider Demographics
NPI:1982718375
Name:DR. JUDD'S OFFICE PROFESSIONAL, LLC
Entity type:Organization
Organization Name:DR. JUDD'S OFFICE PROFESSIONAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:B
Authorized Official - Last Name:JUDD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-770-6500
Mailing Address - Street 1:6081 S QUEBEC ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4536
Mailing Address - Country:US
Mailing Address - Phone:303-770-6500
Mailing Address - Fax:303-770-2211
Practice Address - Street 1:6081 S QUEBEC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4536
Practice Address - Country:US
Practice Address - Phone:303-770-6500
Practice Address - Fax:303-770-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty