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NPI Code Detail

MEDICARE: DR. JULIE LYNN SANFORD M.D.

MEDICARE:  DR. JULIE LYNN SANFORD  M.D.
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
12084P0800XPsychiatry Physician27976CO
22084P0805XGeriatric Psychiatry Physician27976CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1260049680OTHERCORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386686236
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE LYNN SANFORD M.D.
Provider Business Mailing Address
First Line : 6160 TUTT BLVD
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80923-3500
Country : US
Telephone Number : 719-473-2346
Fax Number : 719-577-9627
Provider Business Practice Location Address
First Line : 6160 TUTT BLVD
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80923-3500
Country : US
Telephone Number : 719-473-2346
Fax Number : 719-577-9627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 04/26/2016

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Directions to “ DR. JULIE LYNN SANFORD M.D.” Practice Location

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