Healthcare Provider Details

I. General information

NPI: 1720457963
Provider Name (Legal Business Name): LESLIE A AHLMEYER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 YAMPA AVE
CRAIG CO
81625-2515
US

IV. Provider business mailing address

1600 PINE GROVE RD SUITE 100
STEAMBOAT SPRINGS CO
80487-2118
US

V. Phone/Fax

Practice location:
  • Phone: 970-824-1711
  • Fax: 970-879-8532
Mailing address:
  • Phone: 970-879-8533
  • Fax: 970-879-8532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNN HOOPER
Title or Position: MANAGER
Credential:
Phone: 303-586-9390