Provider Demographics
NPI:1942589130
Name:DR. JACQUELINE AREGOOD, PC
Entity Type:Organization
Organization Name:DR. JACQUELINE AREGOOD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:AREGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-336-7222
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:USAF ACADEMY
Mailing Address - State:CO
Mailing Address - Zip Code:80840-0214
Mailing Address - Country:US
Mailing Address - Phone:703-336-7222
Mailing Address - Fax:
Practice Address - Street 1:2102 UNIVERSITY PARK BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3678
Practice Address - Country:US
Practice Address - Phone:719-444-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO494702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty