| Roaring Fork Neurology, P.c. | |
|
350 Market St Unit 1 Basalt CO 81621-7410 | |
| (970) 927-1141 | |
| (970) 422-7123 |
| Full Name | Roaring Fork Neurology, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 350 Market St Unit 1, Basalt, Colorado |
| Authorized Official Name and Position | Alison Bible Allen (PRESIDENT) |
| Authorized Official Contact | 9709271141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roaring Fork Neurology, P.c. 350 Market St Unit 1 Basalt CO 81621-7410 Ph: (970) 379-0452 | Roaring Fork Neurology, P.c. 350 Market St Unit 1 Basalt CO 81621-7410 Ph: (970) 927-1141 |
| NPI Number | 1417279597 |
|---|---|
| Provider Enumeration Date | 02/17/2010 |
| Last Update Date | 07/13/2023 |
| Certification Date | 12/08/2022 |
| Medicare PECOS PAC ID | 1557494846 |
|---|---|
| Medicare Enrollment ID | O20100806000816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417279597 | NPI | - | NPPES |
| 48812 | Other | CO | CO MED LIC |
| 1285780874 | Other | CO | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 48812 (Colorado) | Primary |
| Provider Name | Alison Allen |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1285780874 PECOS PAC ID: 2466585757 Enrollment ID: I20100806000824 |
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