Provider Demographics
NPI:1851683106
Name:LINK, TIFFANY MARIE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:LINK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 POUDRE RIVER DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3557
Mailing Address - Country:US
Mailing Address - Phone:970-484-3050
Mailing Address - Fax:970-484-3036
Practice Address - Street 1:1100 POUDRE RIVER DR
Practice Address - Street 2:UNIT A
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3557
Practice Address - Country:US
Practice Address - Phone:970-484-3050
Practice Address - Fax:970-484-3036
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO56316207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology