Healthcare Provider Details

I. General information

NPI: 1356579965
Provider Name (Legal Business Name): DAWN VICTORIA OBRECHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51193 SMITH CREEK RD BOX 775596
STEAMBOAT SPRINGS CO
80487-9447
US

IV. Provider business mailing address

PO BOX 775596
STEAMBOAT SPRINGS CO
80477-5596
US

V. Phone/Fax

Practice location:
  • Phone: 303-877-5310
  • Fax:
Mailing address:
  • Phone: 303-877-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19464
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number19464
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: