Provider Demographics
NPI:1306309364
Name:PRESTON, ALLIE KAY (MD)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:KAY
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-0069
Mailing Address - Country:US
Mailing Address - Phone:970-301-0130
Mailing Address - Fax:970-673-4747
Practice Address - Street 1:4038 S TIMBERLINE RD UNIT 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6004
Practice Address - Country:US
Practice Address - Phone:970-673-1155
Practice Address - Fax:970-673-4747
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5794207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology