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NPI Code Detail

MEDICARE: ALLIE KAY PRESTON MD

MEDICARE:   ALLIE KAY PRESTON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianU5794TX

General Provider Information

NPI Number : 1306309364
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLIE KAY PRESTON MD
Provider Business Mailing Address
First Line : PO BOX 69
Second Line :
City : TIMNATH
State : CO
Zip : 80547-0069
Country : US
Telephone Number : 970-301-0130
Fax Number : 970-673-4747
Provider Business Practice Location Address
First Line : 4038 S TIMBERLINE RD UNIT 100
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-6004
Country : US
Telephone Number : 970-673-1155
Fax Number : 970-673-4747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2019
Last Update Date : 07/26/2024

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Directions to “ ALLIE KAY PRESTON MD” Practice Location

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