Provider Demographics
NPI:1700895869
Name:HASELHORST, BETH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:HASELHORST
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 1:2250 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3472
Mailing Address - Country:US
Mailing Address - Phone:719-522-1444
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:CADET CLINIC - 10TH MEDICAL GROUP
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-4000
Practice Address - Country:US
Practice Address - Phone:719-333-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine