Healthcare Provider Details

I. General information

NPI: 1356491393
Provider Name (Legal Business Name): LAUREL REINHART STEARNS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK ROAD SUITE 200
AVON CO
81620
US

IV. Provider business mailing address

PO BOX 5850
EAGLE CO
81631-5850
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax: 970-926-6348
Mailing address:
  • Phone: 970-926-6340
  • Fax: 970-926-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number45968
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number45968
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: