Healthcare Provider Details

I. General information

NPI: 1073180360
Provider Name (Legal Business Name): TORI APPLEGREN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 LAKE PLAZA DR STE 230
COLORADO SPRINGS CO
80906-3512
US

IV. Provider business mailing address

1263 LAKE PLAZA DR STE 230
COLORADO SPRINGS CO
80906-3512
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-3300
  • Fax: 719-776-3329
Mailing address:
  • Phone: 719-776-3300
  • Fax: 573-882-6228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2021020454
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0072828
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: