Provider Demographics
NPI:1558998096
Name:REILEY, HEATHER THOMSON (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:THOMSON
Last Name:REILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 BLAKE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4286
Mailing Address - Country:US
Mailing Address - Phone:970-947-9999
Mailing Address - Fax:970-947-9226
Practice Address - Street 1:1905 BLAKE AVE STE 201
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4286
Practice Address - Country:US
Practice Address - Phone:970-947-9999
Practice Address - Fax:970-947-9226
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0070860208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics