Provider Demographics
NPI:1225112543
Name:RONEY, CRYSTAL WALDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:WALDEN
Last Name:RONEY
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:377 SYLVAN LAKE ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631
Mailing Address - Country:US
Mailing Address - Phone:970-328-6357
Mailing Address - Fax:970-328-2338
Practice Address - Street 1:377 SYLVAN LAKE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-0129
Practice Address - Country:US
Practice Address - Phone:970-328-6357
Practice Address - Fax:970-328-2338
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO35638207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79481027Medicaid
CO79481027Medicaid
COC462248Medicare Oscar/Certification
CO79481027Medicaid