| Organization Name: | DEBORAH GREEN MD PC |
| NPI Number: | 1194909804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY SALAS (OWNER) |
| Mailing Address: | 315 Park Ave Fort Lupton |
| State: | CO US |
| Postal Code: | 806211929 |
| Phone Number: | 3038576111 |
| Fax Number: | 3038572459 |
| NPI Enumeration Date: | 12/18/2007 |
| NPI Last Update Date: | 08/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 241330 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |