Healthcare Provider Details

I. General information

NPI: 1205817855
Provider Name (Legal Business Name): ORALEE L EKBERG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 W 7TH ST
WRAY CO
80758-1420
US

IV. Provider business mailing address

425 S CHERRY ST SUITE 907
DENVER CO
80246-1226
US

V. Phone/Fax

Practice location:
  • Phone: 970-332-4895
  • Fax: 970-332-2328
Mailing address:
  • Phone: 303-321-2255
  • Fax: 303-321-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number41813
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: