| Shannon Quirk Detty, MD | |
|
2880 Folsom St Ste 200, Boulder, CO 80304-3769 | |
| (303) 442-6647 | |
| (303) 442-2696 |
| Full Name | Shannon Quirk Detty |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 13 Years |
| Location | 2880 Folsom St Ste 200, Boulder, Colorado |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790149763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 6600-851 (Wisconsin) | Secondary |
| 207N00000X | Dermatology | 70147 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dermatology Specialists Of Boulder Pc | 3678668761 | 12 |
| Entity Name | Advanced Dermatology Skin Cancer & Laser Surgery Center P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134170012 PECOS PAC ID: 6709775133 Enrollment ID: O20040313000244 |
| Entity Name | Dermatology Specialists Of Boulder Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053449306 PECOS PAC ID: 3678668761 Enrollment ID: O20071004000308 |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Quirk Detty, MD 600 Highland Ave, Madison, WI 53792-0001 Ph: () - | Shannon Quirk Detty, MD 2880 Folsom St Ste 200, Boulder, CO 80304-3769 Ph: (303) 442-6647 |
Shawn B Allen, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2880 Folsom St Ste 200, Boulder, CO 80304 Phone: 303-442-6647 Fax: 303-442-2696 | |
Mr. William Crane Fix, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3434 47th St Ste 200, Boulder, CO 80301 Phone: 303-444-8100 | |
Dr. Steven D Resnick, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 3575 Broadway St, Boulder, CO 80304 Phone: 303-449-0933 Fax: 303-447-0794 | |
John R Steinbaugh, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 3575 Broadway St, Boulder, CO 80304 Phone: 303-449-0933 Fax: 303-447-0794 | |
Dr. Brian N Bailey, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1230 Chambers Dr, Boulder, CO 80305 Phone: 303-666-8288 | |
Lindsay Nicole Boyers, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2750 Broadway St, Boulder, CO 80304 Phone: 303-440-3013 Fax: 303-440-3178 | |
Steven R Hong, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2750 Broadway St, Boulder, CO 80304 Phone: 303-440-3000 |