Healthcare Provider Details

I. General information

NPI: 1871789032
Provider Name (Legal Business Name): MESA COUNTY HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 29.5 RD
GRAND JUNCTION CO
81504-5383
US

IV. Provider business mailing address

510 29.5 RD
GRAND JUNCTION CO
81504-5383
US

V. Phone/Fax

Practice location:
  • Phone: 970-248-6900
  • Fax: 970-248-6913
Mailing address:
  • Phone: 970-248-6900
  • Fax: 970-248-6913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number74009
License Number StateCO

VIII. Authorized Official

Name: DR. MICHAEL ADUDDELL
Title or Position: DIRECTOR
Credential: DO
Phone: 970-248-6974