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General NPI Number Information
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NPI Number | 1124491998
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Entity Type | Individual
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Provider Name | DYLAN ALLEN HARTLEY CAA
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Gender | Male
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 8000 E MAPLEWOOD AVE STE 200
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4727
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Country | US
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Telephone | 303-438-3999
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Fax | 720-439-9500
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Provider Business Mailing Address
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Address Line | PO BOX 840862
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City | DALLAS
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State | TX
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Zip | 75284-5429
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Country | US
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Telephone | 303-377-7638
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Fax | 720-439-9500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 152
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | ANT.0000050
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License Number State | CO
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