Healthcare Provider Details

I. General information

NPI: 1891019972
Provider Name (Legal Business Name): ALAN PUDDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 S UNION BLVD STE 310
COLORADO SPRINGS CO
80910-3126
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-1950
  • Fax: 719-365-1951
Mailing address:
  • Phone: 970-624-4451
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number26530
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDR.0062917
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: