Healthcare Provider Details

I. General information

NPI: 1558505081
Provider Name (Legal Business Name): DAREL JOHN HULSING DAREL HULSING,M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAREL JOHN HULSING DAREL HULSING,M.D.

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1743 AVALON DR
ESTES PARK CO
80517-7358
US

IV. Provider business mailing address

1743 AVALON DR
ESTES PARK CO
80517-7358
US

V. Phone/Fax

Practice location:
  • Phone: 970-577-0079
  • Fax:
Mailing address:
  • Phone: 970-577-0079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number37366
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: