Doctor Name: | DR. TODD HOWZE OVERTON |
NPI Number: | 1104263045 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | DR0049559 |
Business Practice Address: | 2638 Medinah Dr Evergreen, CO - 804398905 |
Business Phone Number: | 5056995334 |
Business Fax Number: | |
Mailing Address: | Po Box 3999, EVERGREEN |
State: | CO |
Postal Code: | 804373999 |
Phone Number: | 5056995334 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2013 |
NPI Last Update Date: | 06/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | DR0049559 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |