Provider Demographics
NPI:1073508966
Name:HALLING, JULIE LYNN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LYNN
Last Name:HALLING
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34599207QG0300X
CO45066207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG94833Medicare UPIN
AZZ106470Medicare PIN
COC808134Medicare PIN