Healthcare Provider Details

I. General information

NPI: 1700972809
Provider Name (Legal Business Name): ELIZABETH FLOOD SPIDELL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH R. FLOOD D.O.

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 HWY. 133
CARBONDALE CO
81623
US

IV. Provider business mailing address

978 EUCLID AVE
CARBONDALE CO
81623-1839
US

V. Phone/Fax

Practice location:
  • Phone: 970-963-3350
  • Fax: 970-963-2958
Mailing address:
  • Phone: 970-963-3350
  • Fax: 970-963-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42950
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: