Basic Information
| Provider Information | |||||||||
| NPI: | 1902839087 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAPP | ||||||||
| FirstName: | BARRY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 N GRAND AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | PUEBLO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810032755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195957700 | ||||||||
| FaxNumber: | 7195957719 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 N GRAND AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | PUEBLO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810032755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195957700 | ||||||||
| FaxNumber: | 7195957719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01177724 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.