Healthcare Provider Details

I. General information

NPI: 1700908068
Provider Name (Legal Business Name): GISELLE ZAGARI STUPPIELLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GISELLE ZAGARI

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N CZECH HALL RD
YUKON OK
73099-7897
US

IV. Provider business mailing address

1241 W MINERAL AVE SUITE 100
LITTLETON CO
80120-5685
US

V. Phone/Fax

Practice location:
  • Phone: 405-494-8600
  • Fax:
Mailing address:
  • Phone: 303-759-0854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number36779
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: