Individual
JOHN LAWRENCE HEGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2222 N NEVADA AVENUE, COLORADO SPRINGS, CO 80907
(719) 776-5000
Mailing address
PO BOX 744127, DALLAS, TX 75374-0968
(719) 776-5816
(719) 776-2108
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
23966
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
G7526
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01239664
—
CO
Enumeration date
04/18/2006
Last updated
07/08/2007
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