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BROOKE M HALLIWELL DO
>> Obstetrics & Gynecology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1508078759
Individual Registrant: BROOKE M HALLIWELL DO
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1830 BLAKE AVENUE SUITE 208 GLENWOOD SPGS, CO 81601-4592 US
Tel: 970-945-2238 Fax: 970-928-8926
Tel: 970-945-2238 Fax: 970-928-8926
Contact information for business:
1830 BLAKE AVENUE SUITE 208 GLENWOOD SPGS, CO 81601-4592 US
Tel: 970-945-2238 Fax: 970-928-8926
Tel: 970-945-2238 Fax: 970-928-8926
Registration Information:
NPI: 1508078759
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207V00000X | Allopathic & Osteopathic Physicians Obstetrics & Gynecology | PA | OT012106 |
| Y | 207V00000X | Allopathic & Osteopathic Physicians Obstetrics & Gynecology | CO | 49947 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NPI | 1508078759 | 01 | |
| 61273546 | CO | 05 | |
| LICENSE | 49947 | CO | 01 |
