Provider Demographics
NPI:1932158763
Name:TOLBY, REBECCA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUE
Last Name:TOLBY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:715 HORIZON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8726
Mailing Address - Country:US
Mailing Address - Phone:970-241-7484
Mailing Address - Fax:970-241-7353
Practice Address - Street 1:715 HORIZON DR STE 200
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8726
Practice Address - Country:US
Practice Address - Phone:970-241-7484
Practice Address - Fax:970-241-7353
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2016-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO36278207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01362789Medicaid
CO01362789Medicaid
COC801389Medicare PIN