Provider Demographics
NPI:1346278637
Name:GUTIERREZ, HILARIE J (MD)
Entity type:Individual
Prefix:
First Name:HILARIE
Middle Name:J
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 800022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0022
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:1380 TULIP ST STE B
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3157
Practice Address - Country:US
Practice Address - Phone:303-651-5160
Practice Address - Fax:303-651-5173
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00357472085R0202X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF2008OtherBCBS
CO01357474Medicaid
COP00277729OtherRAILROAD MEDICARE
COG38890Medicare UPIN
CO01357474Medicaid
COP00277729OtherRAILROAD MEDICARE