Individual
DR. DEBRA ANNE IRIZARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
46 CAMINO BACA GRANDE, SUITE #102, CRESTONE, CO 81131
(719) 256-6600
(719) 256-5796
Mailing address
PO BOX 749, CRESTONE, CO 81131-0749
(719) 256-6600
(719) 256-5796
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
1679111
NY
208200000X
Plastic Surgery Physician
46205
CO
208200000X
Plastic Surgery Physician
9677
NM
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
46205
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72651
WORKERS COMP
—
Enumeration date
09/05/2008
Last updated
03/19/2021
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