Basic Information
| Provider Information | |||||||||
| NPI: | 1700159555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORMOND | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | RYAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12631 E 17TH AVE | ||||||||
| Address2: | ACADEMIC OFFICE 1, ROOM 5001, MAILSTOP C307 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037242284 | ||||||||
| FaxNumber: | 3037242300 | ||||||||
| Practice Location | |||||||||
| Address1: | 12631 E 17TH AVE | ||||||||
| Address2: | ACADEMIC OFFICE 1, ROOM 5001, MAILSTOP C307 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037242284 | ||||||||
| FaxNumber: | 3037242300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2012 | ||||||||
| LastUpdateDate: | 04/22/2014 | ||||||||
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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 | 207T00000X | 67516 | GA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 267037 | NY | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 003125626B | 05 | GA | MEDICAID |