Provider Demographics
NPI:1619283991
Name:VARGAS, ALAN-MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN-MICHAEL
Middle Name:
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 AIRPORT RD
Mailing Address - Street 2:PO BOX 912
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-8510
Mailing Address - Country:US
Mailing Address - Phone:970-625-1100
Mailing Address - Fax:
Practice Address - Street 1:201 SIPPRELLE DR
Practice Address - Street 2:
Practice Address - City:PARACHUTE
Practice Address - State:CO
Practice Address - Zip Code:81635-9234
Practice Address - Country:US
Practice Address - Phone:970-625-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52214207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08373272Medicaid
CO313869YMJ3Medicare PIN