Individual
DR. SUSAN L BLAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36871
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01368711
—
CO
01
—
017468
KAISER COMMERCIAL NUMBER
CO
Enumeration date
09/15/2005
Last updated
05/17/2021
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