Individual
DEAN M HAVLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2351 G ROAD, COMMUNITY HOSPITAL, GRAND JUNCTION, CO 81505
(970) 644-3283
Mailing address
PO BOX 4235, GRAND JUNCTION, CO 81502
(970) 256-6463
(970) 256-6512
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
39245
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06629733
—
CO
01
—
220030307
RAILROAD MEDICARE
—
05
—
T0328
—
UT
Enumeration date
10/31/2005
Last updated
02/03/2020
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