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NPI Code Detail

MEDICARE: DR. TODD E. HEGSTROM MD

MEDICARE:  DR. TODD E. HEGSTROM  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
12085R0202XDiagnostic Radiology PhysicianDR.0025745CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669474896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD E. HEGSTROM MD
Provider Business Mailing Address
First Line : PO BOX 308
Second Line :
City : MONTROSE
State : CO
Zip : 81402-0308
Country : US
Telephone Number : 970-497-8416
Fax Number : 970-467-8410
Provider Business Practice Location Address
First Line : 2351 G RD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-9641
Country : US
Telephone Number : 970-644-3237
Fax Number : 970-644-3259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/17/2019

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Directions to “ DR. TODD E. HEGSTROM MD” Practice Location

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