Individual
MRS. TALENA COX WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
181 W MEADOW DR, SUITE 400, VAIL, CO 81657-5242
(970) 479-5792
(970) 479-5862
Mailing address
181 W MEADOW DR, SUITE 400, VAIL, CO 81657-5242
(970) 479-5792
(970) 479-5862
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0110001693
VA
363AS0400X
Surgical Physician Assistant
Primary
PA0004483
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184602823
MEDICAID QMB
VA
01
—
371194700
BLACK LUNG
VA
01
—
540506332115
TRICARE/CHAMPUS
VA
01
—
P00847896
RAILROAD MEDICARE
VA
Enumeration date
01/04/2006
Last updated
08/12/2016
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