Healthcare Provider Details

I. General information

NPI: 1225380439
Provider Name (Legal Business Name): SARAH E JUDKINS, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E STAR CT STE A
MONTROSE CO
81401-6704
US

IV. Provider business mailing address

611 E STAR CT STE A
MONTROSE CO
81401-6704
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-4321
  • Fax: 970-249-2339
Mailing address:
  • Phone: 970-249-4321
  • Fax: 970-249-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number50094
License Number StateCO

VIII. Authorized Official

Name: SARAH JUDKINS
Title or Position: PRESIDENT
Credential: MD
Phone: 303-908-1731