Provider Demographics
NPI:1912161456
Name:NEALON, ERIN ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:NEALON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 MAIN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4258
Mailing Address - Country:US
Mailing Address - Phone:970-764-9300
Mailing Address - Fax:
Practice Address - Street 1:3235 MAIN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4258
Practice Address - Country:US
Practice Address - Phone:970-764-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.052768207R00000X
NMA-1544-10207R00000X
CO55603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine