Provider Demographics
NPI:1992921837
Name:JULIE HALLING MD PC
Entity type:Organization
Organization Name:JULIE HALLING MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HALLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:719-632-8787
Mailing Address - Street 1:3076 ELECTRA DR S
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-1097
Mailing Address - Country:US
Mailing Address - Phone:719-632-8787
Mailing Address - Fax:866-848-5096
Practice Address - Street 1:3076 ELECTRA DR S
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-1097
Practice Address - Country:US
Practice Address - Phone:719-632-8787
Practice Address - Fax:866-848-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34599207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG94833Medicare UPIN
AZZ106471Medicare PIN