Healthcare Provider Details

I. General information

NPI: 1699821363
Provider Name (Legal Business Name): SARAH JUDKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TESSITORE CT UNIT B
MONTROSE CO
81401-5689
US

IV. Provider business mailing address

100 TESSITORE CT UNIT B
MONTROSE CO
81401-5689
US

V. Phone/Fax

Practice location:
  • Phone: 970-787-4710
  • Fax: 970-249-2339
Mailing address:
  • Phone: 970-787-4710
  • 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:
Title or Position:
Credential:
Phone: