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General NPI Number Information
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NPI Number | 1336058684
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Entity Type | Organization
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Legal Business Name | WINDSOR DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 2121 E HARMONY RD UNIT 310
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City | FORT COLLINS
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State | CO
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Zip | 80528-3403
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Country | US
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Telephone | 970-667-0304
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Fax | 970-669-5153
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Provider Business Mailing Address
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Address Line | 4025 ST CLOUD DR STE 110
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City | LOVELAND
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State | CO
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Zip | 80538-8960
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Country | US
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Telephone | 970-667-0304
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Fax | 970-669-5153
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMMON JEAN LARSEN
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Credential | MD
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Telephone | 970-667-0304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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