Healthcare Provider Details

I. General information

NPI: 1831130160
Provider Name (Legal Business Name): CYNTHIA LEE HALL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BLAKE AVE 1A
GLENWOOD SPRINGS CO
81601-4249
US

IV. Provider business mailing address

2001 BLAKE AVE 1A
GLENWOOD SPRINGS CO
81601-4249
US

V. Phone/Fax

Practice location:
  • Phone: 970-384-2000
  • Fax: 970-384-2211
Mailing address:
  • Phone: 970-384-2000
  • Fax: 970-384-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43197
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: