Healthcare Provider Details

I. General information

NPI: 1932323037
Provider Name (Legal Business Name): JOHN F ALSTON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30752 SOUTHVIEW DRIVE SUITE 100
EVERGREEN CO
80439
US

IV. Provider business mailing address

30752 SOUTHVIEW DRIVE SUITE 100
EVERGREEN CO
80439
US

V. Phone/Fax

Practice location:
  • Phone: 303-670-0926
  • Fax: 303-670-1191
Mailing address:
  • Phone: 303-670-0926
  • Fax: 303-670-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOHN FRAZIER ALSTON
Title or Position: PRESIDENT
Credential: MD
Phone: 303-670-0926