Healthcare Provider Details

I. General information

NPI: 1417006768
Provider Name (Legal Business Name): TIFFANY LYNN ANCHERIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W 92ND AVE STE 104
WESTMINSTER CO
80031-3304
US

IV. Provider business mailing address

6080 W 92ND AVE SUITE 1000
WESTMINSTER CO
80031-2928
US

V. Phone/Fax

Practice location:
  • Phone: 303-429-6600
  • Fax: 720-235-4738
Mailing address:
  • Phone: 303-427-0796
  • Fax: 303-429-9399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number44611
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number44611
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: