Provider Demographics
NPI:1174568653
Name:PALAGI, PATRICIA C (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:C
Last Name:PALAGI
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 1:702 W DRAKE RD # A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5556
Mailing Address - Country:US
Mailing Address - Phone:970-229-4653
Mailing Address - Fax:970-229-4687
Practice Address - Street 1:702 W DRAKE RD # A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5556
Practice Address - Country:US
Practice Address - Phone:970-229-4653
Practice Address - Fax:970-229-4687
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8914062Medicare PIN
COG43441Medicare UPIN