Willard, Tiffany Marie

Willard, Tiffany Marie is an individual health care provider with primary practice located at 1400 E Boulder St Suite 600, Colorado Springs CO 80909-5533. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Critical Care, which is considered as her primary health care specialty. Willard, Tiffany Marie can be contacted via phone (719) 364-6487.

Contact Information

Primary practice address
1400 E Boulder St Suite 600 Colorado Springs CO 80909-5533
Phone: (719) 364-6487
Fax: (719) 364-6488
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X DR.0046934 Colorado

Profile Details

NPI number 1396769436
LBN Legal business name Willard, Tiffany Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Dec 19th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396769436 NPPES
Colorado MEDICAID 20634064

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