1427048198 NPI number — GREGORY F MCAULIFFE MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427048198 NPI number — GREGORY F MCAULIFFE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCAULIFFE
Provider First Name:
GREGORY
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427048198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 BLANCA AVE
Provider Second Line Business Mailing Address:
SLV REGIONAL MEDICAL CENTER
Provider Business Mailing Address City Name:
ALAMOSA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81101-2340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-589-8005
Provider Business Mailing Address Fax Number:
719-589-8023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 BLANCA AVE
Provider Second Line Business Practice Location Address:
SLV REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
ALAMOSA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81101-2340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-589-8005
Provider Business Practice Location Address Fax Number:
719-589-8023
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  44010 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HP33679 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 08022001 . This is a "MMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 241141 . This is a "ARAZ GROUP AMERICAS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 767663800 . This is a "MEDICAL ASSISTANCE MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0403073 . This is a "MEDICA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1028017 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 767663800 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50F29MC . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110225228 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 140947 . This is a "UCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2114114 . This is a "FIRST HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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