Central Colorado Dermatology, P.C.
Organization Active NPI Dermatology Physician · Salida, CO
NPI 1417128455 · NPPES record last updated Feb 7, 2011
Key facts
- NPI
- 1417128455
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 39785 (CO)
- Legal business name
- CENTRAL COLORADO DERMATOLOGY, P.C.
- Practice address
- 925 Rush Dr
Salida, CO 81201-9665 - Phone
- (719) 539-4600
- Fax
- (719) 539-4629
- NPI assigned
- Mar 18, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony Louis Timko
- Title
- President
- Phone
- (719) 539-4600
Practitioners 1
National Provider Directory
Locations
120 Blanca Ave
Alamosa, CO 81101
Phone (719) 587-1290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | 39785 | CO | Yes |
Addresses
Primary practice location
925 Rush Dr
Salida, CO 81201-9665
Mailing address
PO Box 849
Salida, CO 81201-0849
Phone (719) 539-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35180846 | Medicaid | CO |
Other providers in Salida, CO
- Allyson Caputa
- Caritas Psychotherapy & Consultation, LLC
- Carolyn Casey
- Mary Cornthwaite Cates
- Catholic Health Initiatives Colorado
- Central Colorado Ear Nose & Throat PLLC
- Gretchen Lynette Chamberlain
- Mardi L Chambers
- Nicholas Jordan Chariton
- Chimera Counseling PLLC
All providers in Salida, CO · Dermatology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.