Healthcare Provider Details

I. General information

NPI: 1174599575
Provider Name (Legal Business Name): DAVID DANIELL HAIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 SILVERSMITH RD
COLORADO SPRINGS CO
80921-7225
US

IV. Provider business mailing address

1615 SILVERSMITH RD
COLORADO SPRINGS CO
80921-7225
US

V. Phone/Fax

Practice location:
  • Phone: 719-633-5255
  • Fax: 719-488-6753
Mailing address:
  • Phone: 719-633-5255
  • Fax: 719-488-6753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9901191
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDR.0064719
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: