Healthcare Provider Details

I. General information

NPI: 1134447477
Provider Name (Legal Business Name): FALAN MOUTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PRAIRIE CENTER PKWY
BRIGHTON CO
80601-4006
US

IV. Provider business mailing address

2700 DECATUR ST APT 521
DENVER CO
80211-4375
US

V. Phone/Fax

Practice location:
  • Phone: 303-498-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberDR.0059999
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDR.0059999
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: