Organization
ENT CLINIC OF PUEBLO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN NEWBURG MD (OWNER/PROVIDER)
(714) 544-3752
Entity
Organization
Contact information
Practice address
1304 N GRAND AVE, PUEBLO, CO 81003-2718
(719) 544-3752
(719) 542-1794
Mailing address
1304 N GRAND AVE, PUEBLO, CO 81003-2718
(719) 544-3752
(719) 542-1794
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52280322
—
CO
Enumeration date
04/05/2010
Last updated
04/06/2010
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