MEDICARE: ROBERT W CALHOUN PHD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	814	CO

General Provider Information

NPI Number	:	1720270044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT W CALHOUN PHD PC

Provider Business Mailing Address
First Line	:	1302 S SHIELDS ST
Second Line	:	A2-2
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4801
Country	:	US
Telephone Number	:	970-493-8006
Fax Number	:	970-493-8009

Provider Business Practice Location Address
First Line	:	1302 S SHIELDS ST
Second Line	:	A2-2
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4801
Country	:	US
Telephone Number	:	970-493-8006
Fax Number	:	970-493-8009

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT W CALHOUN
Credential	:	PH.D.
Telephone Number	:	970-493-8006

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	08/10/2007

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