MEDICARE: GEORGE ELTON VALLEY M.D.

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	207Q00000X	Family Medicine Physician	22787	CO

General Provider Information

NPI Number	:	1952347460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ELTON VALLEY M.D.

Provider Business Mailing Address
First Line	:	3000 S COLLEGE AVE
Second Line	:	STE 210
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2558
Country	:	US
Telephone Number	:	970-266-8822
Fax Number	:	970-266-8833

Provider Business Practice Location Address
First Line	:	3000 S COLLEGE AVE
Second Line	:	STE 210
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2558
Country	:	US
Telephone Number	:	970-266-8822
Fax Number	:	970-266-8833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	03/19/2008

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