Healthcare Provider Details

I. General information

NPI: 1487781423
Provider Name (Legal Business Name): BECKY B ESTILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9139 SOUTH RIDGELINE BOULEVARD SUITE 210
HIGHLANDS RANCH CO
80129-2333
US

IV. Provider business mailing address

9139 SOUTH RIDGELINE BOULEVARD SUITE 210
HIGHLANDS RANCH CO
80129-2333
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-3800
  • Fax:
Mailing address:
  • Phone: 303-338-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number33432
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: