Provider Demographics
NPI:1013084888
Name:TRAUTNER, PAULA M (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:TRAUTNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:CO
Mailing Address - Zip Code:81433-0462
Mailing Address - Country:US
Mailing Address - Phone:970-249-6116
Mailing Address - Fax:970-249-6116
Practice Address - Street 1:150 ROCK POINT DR STE B
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7727
Practice Address - Country:US
Practice Address - Phone:970-249-6116
Practice Address - Fax:970-249-6116
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT 13915412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01242957Medicaid
COC10069Medicare PIN
COC90631Medicare PIN