Individual
DR. RICHARD LYLE STALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
30940 STAGECOACH BLVD, SUITE E290, EVERGREEN, CO 80439-7984
(303) 674-8153
(303) 674-8303
Mailing address
30940 STAGECOACH BLVD, SUITE E290, EVERGREEN, CO 80439-7984
(303) 674-8153
(303) 674-8303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25525
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01255256
—
CO
01
—
1016326
AETNA
CO
01
—
38662
BCBS
CO
Enumeration date
04/27/2006
Last updated
07/08/2007
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