Healthcare Provider Details

I. General information

NPI: 1326151754
Provider Name (Legal Business Name): CAITLIN M AHERN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 MAIN AVE
AKRON CO
80720-1440
US

IV. Provider business mailing address

1000 W 8TH AVE
YUMA CO
80759-2641
US

V. Phone/Fax

Practice location:
  • Phone: 970-345-6336
  • Fax: 970-848-5472
Mailing address:
  • Phone: 970-345-6336
  • Fax: 970-848-5475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33643
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: