Basic Information
| Provider Information | |||||||||
| NPI: | 1487975579 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEN | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10700 E GEDDES AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204933716 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Practice Location | |||||||||
| Address1: | 10700 E GEDDES AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204933716 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2010 | ||||||||
| LastUpdateDate: | 12/07/2018 | ||||||||
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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 | 2085N0700X | DR.0061043 | CO | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | DR.0061043 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 688558 | 01 | CO | MEDICARE | OTHER | 690523 | 01 | CO | MEDICARE | OTHER | 690572 | 01 | CO | MEDICARE | OTHER | 688557 | 01 | CO | MEDICARE | OTHER | 681417 | 01 | CO | MEDICARE | OTHER | NA1215136 | 01 | NE | MEDICARE | OTHER | KA3249112 | 01 | KS | MEDICARE PTAN | OTHER | NA2517112 | 01 | NE | MEDICARE | OTHER | 681442 | 01 | CO | MEDICARE | OTHER | NA1214135 | 01 | NE | MEDICARE | OTHER | 111257121 | 01 | KS | MEDICARE PTAN | OTHER |