Provider Demographics
NPI:1538466537
Name:CASSIDY, UGNE (DO)
Entity Type:Individual
Prefix:DR
First Name:UGNE
Middle Name:
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 HACIENDA ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507
Mailing Address - Country:US
Mailing Address - Phone:630-606-0080
Mailing Address - Fax:
Practice Address - Street 1:2351 G RD
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505
Practice Address - Country:US
Practice Address - Phone:970-644-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059771207P00000X
IN02004326A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine