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Individual

VICKY A VANDERPOOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2600 CAMPUS DR, STE A, LAFAYETTE, CO 80026-3357
(303) 665-1900
(303) 926-1781
Mailing address
DEPT 557, DENVER, CO 80291-0557
(303) 467-4155
(303) 467-4156

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29675
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01296755
CO
01
P00359278
MEDICARE RAILROAD
Enumeration date
06/03/2006
Last updated
12/17/2007
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