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Individual

DR. LONNIE L IMLAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1650 COCHRANE CIR UNIT MEDDAC, FT CARSON, CO 80913-4604
(719) 524-4166
(719) 524-4183
Mailing address
1650 COCHRANE CIR UNIT MEDDAC, FT CARSON, CO 80913-4604
(719) 524-4166
(719) 524-4183

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29224
IA
208600000X
Surgery Physician
Primary
44366
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45707731
CO
Enumeration date
03/01/2006
Last updated
02/21/2025
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