Individual
GEORGE A DEVAULT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1914 LELARAY ST, COLORADO SPRINGS, CO 80909-2800
(719) 632-7641
(719) 632-2925
Mailing address
1914 LELARAY ST, COLORADO SPRINGS, CO 80909-2800
(719) 632-7641
(719) 632-2925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37136
CO
207RN0300X
Nephrology Physician
Primary
37136
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1371368
—
CO
Enumeration date
12/13/2005
Last updated
02/11/2016
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