Individual
SOLOMON VILLALON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
809 MAIN ST, SUITE #3, WALSENBURG, CO 81089-2149
(719) 738-2606
(719) 738-1746
Mailing address
PO BOX 150, 809 MAIN ST. STE 3, WALSENBURG, CO 81089-0150
(719) 738-2606
(719) 738-1746
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20315
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01203157
—
CO
Enumeration date
06/17/2005
Last updated
11/24/2009
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