Individual
KYLE B WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6801 W 20TH ST UNIT 101, GREELEY, CO 80634-9640
(970) 378-8000
(970) 378-8088
Mailing address
6801 W 20TH ST UNIT 101, GREELEY, CO 80634-9640
(970) 378-8026
(970) 378-8088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR39604
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07820020
—
CO
Enumeration date
10/19/2005
Last updated
04/09/2020
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