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General NPI Number Information
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NPI Number | 1952099749
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Entity Type | Organization
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Legal Business Name | COLORADO OTOLARYNGOLOGY ASSOCIATES
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 3595 E. SPAULDING AVENUE STE. B
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City | PUEBLO
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State | CO
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Zip | 81008
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Country | US
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Telephone | 719-867-7800
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Fax | 719-867-7899
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Provider Business Mailing Address
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Address Line | PO BOX 9190
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City | COLORADO SPRINGS
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State | CO
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Zip | 80932
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Country | US
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Telephone | 719-867-7800
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Fax | 719-867-7899
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Authorized Official
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Title or Position | CEO
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Name | NOAH LAZARUS
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Credential |
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Telephone | 719-867-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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