MEDICARE: MESA COUNTY HEALTH DEPT

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
1	251K00000X	Public Health or Welfare Agency	74009	CO

General Provider Information

NPI Number	:	1871789032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESA COUNTY HEALTH DEPT

Provider Business Mailing Address
First Line	:	510 29.5 RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81504-5383
Country	:	US
Telephone Number	:	970-248-6900
Fax Number	:	970-248-6913

Provider Business Practice Location Address
First Line	:	510 29.5 RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81504-5383
Country	:	US
Telephone Number	:	970-248-6900
Fax Number	:	970-248-6913

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MICHAEL ADUDDELL
Credential	:	DO
Telephone Number	:	970-248-6974

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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Directions to “MESA COUNTY HEALTH DEPT ” Practice Location

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