Provider Demographics
NPI:1225299803
Name:NORTH, CRYSTAL M (DO)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:M
Last Name:NORTH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3702 S TIMBERLINE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3624
Mailing Address - Country:US
Mailing Address - Phone:970-207-9773
Mailing Address - Fax:970-207-1893
Practice Address - Street 1:2555 E 13TH ST STE 220
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5136
Practice Address - Country:US
Practice Address - Phone:970-669-5432
Practice Address - Fax:970-461-6275
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO44244207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38808048Medicaid
P00737929OtherMEDICARE RAILROAD
CO38808048Medicaid
NE84081574413Medicaid