Provider Demographics
NPI:1225018633
Name:HALLMARK, BELTON DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:BELTON
Middle Name:DOUGLAS
Last Name:HALLMARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17837
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4073
Mailing Address - Country:US
Mailing Address - Phone:303-688-3434
Mailing Address - Fax:303-688-4454
Practice Address - Street 1:1189 S PERRY ST STE 230
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1959
Practice Address - Country:US
Practice Address - Phone:303-688-3434
Practice Address - Fax:303-688-4454
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO23157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01231570Medicaid
TXG0423OtherTEXAS LICENSE
CO01231570Medicaid