Provider Demographics
NPI:1720457963
Name:LESLIE A AHLMEYER MD PC
Entity Type:Organization
Organization Name:LESLIE A AHLMEYER MD PC
Other - Org Name:YAMPA VALLEY OB GYN PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-586-9390
Mailing Address - Street 1:1600 PINE GROVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-2118
Mailing Address - Country:US
Mailing Address - Phone:970-879-8533
Mailing Address - Fax:970-879-8532
Practice Address - Street 1:651 YAMPA AVE
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2515
Practice Address - Country:US
Practice Address - Phone:970-824-1711
Practice Address - Fax:970-879-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty