Healthcare Provider Details

I. General information

NPI: 1205921699
Provider Name (Legal Business Name): MARGOT ANNE CROSSLEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/07/2023
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6965 TUTT BLVD STE 100
COLORADO SPRINGS CO
80923-3597
US

IV. Provider business mailing address

6965 TUTT BLVD STE 100
COLORADO SPRINGS CO
80923-3597
US

V. Phone/Fax

Practice location:
  • Phone: 719-266-5944
  • Fax: 719-266-5947
Mailing address:
  • Phone: 719-266-5944
  • Fax: 719-266-5947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34758
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: