1275519670 NPI number — DR. JULIE KRELL HALL MD

Table of content: DR. JULIE KRELL HALL MD (NPI 1275519670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275519670 NPI number — DR. JULIE KRELL HALL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALL
Provider First Name:
JULIE
Provider Middle Name:
KRELL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KRELL
Provider Other First Name:
JULIE
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275519670
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7337 E COUNTY LINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGMONT
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80504-8430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-579-5922
Provider Business Mailing Address Fax Number:
877-541-9457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 S AIRPORT ROAD SUITE G BUILDING A
Provider Second Line Business Practice Location Address:
IN CIRCLE OF HEALTH
Provider Business Practice Location Address City Name:
LONGMONT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-480-1981
Provider Business Practice Location Address Fax Number:
303-647-3356
Provider Enumeration Date:
12/16/2005

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: 207P00000X , with the licence number:  41565 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 25689088 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00043257 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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