Healthcare Provider Details
I. General information
NPI: 1750369534
Provider Name (Legal Business Name): HAYES K SCHLUNDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/03/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1906 BLAKE AVE
GLENWOOD SPGS CO
81601-4227
US
IV. Provider business mailing address
PO BOX 2023
GLENWOOD SPGS CO
81602-2023
US
V. Phone/Fax
- Phone: 970-945-6535
- Fax:
- Phone: 970-945-1443
- Fax: 970-947-9410
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 30347 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: