Healthcare Provider Details

I. General information

NPI: 1053442467
Provider Name (Legal Business Name): HOUSE CALL DOCS CS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 ORION DRIVE
COLORADO SPRINGS CO
80906-1015
US

IV. Provider business mailing address

506 ORION DRIVE
COLORADO SPRINGS CO
80906-1015
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-8787
  • Fax: 866-848-5096
Mailing address:
  • Phone: 719-632-8787
  • Fax: 866-848-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number45066
License Number StateCO

VIII. Authorized Official

Name: DR. JULIE LYNN HALLING
Title or Position: MANAGER
Credential: MD PHD
Phone: 719-632-8787