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General NPI Number Information
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NPI Number | 1205466497
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Entity Type | Organization
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Legal Business Name | HUMMINGBIRD PSYCHIATRY
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 204 WALNUT ST STE F
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City | FORT COLLINS
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State | CO
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Zip | 80524-4441
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Country | US
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Telephone | 802-316-8116
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Fax | 608-360-9104
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Provider Business Mailing Address
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Address Line | 204 WALNUT ST STE F
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City | FORT COLLINS
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State | CO
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Zip | 80524-4441
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Country | US
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Telephone | 802-316-8116
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Fax | 608-360-9104
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Authorized Official
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Title or Position | OWNER
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Name | DR. DUSTIN DIPPEN
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Credential | MD
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Telephone | 802-316-8116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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