Provider Demographics
NPI:1245224484
Name:MORFORD, MANDY JANINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MANDY
Middle Name:JANINE
Last Name:MORFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:316 SAWYER DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6560
Mailing Address - Country:US
Mailing Address - Phone:970-259-3110
Mailing Address - Fax:970-259-6605
Practice Address - Street 1:316 SAWYER DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6560
Practice Address - Country:US
Practice Address - Phone:970-259-3110
Practice Address - Fax:970-259-6605
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO43743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH18383Medicare UPIN