Healthcare Provider Details

I. General information

NPI: 1184533424
Provider Name (Legal Business Name): WINDSOR DERMATOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 S 8TH AVE STE 102
STERLING CO
80751-4560
US

IV. Provider business mailing address

4025 ST CLOUD DR STE 110
LOVELAND CO
80538-8960
US

V. Phone/Fax

Practice location:
  • Phone: 970-667-0304
  • Fax: 970-669-5153
Mailing address:
  • Phone: 970-667-0304
  • Fax: 970-669-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AMMON JEAN LARSEN
Title or Position: OWNER
Credential: MD
Phone: 970-667-0304