Basic Information
| Provider Information | |||||||||
| NPI: | 1154317006 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALLMARK | ||||||||
| FirstName: | HUGH | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 MEADOWS BLVD | ||||||||
| Address2: | |||||||||
| City: | CASTLE ROCK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801098405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204553879 | ||||||||
| FaxNumber: | 7204550665 | ||||||||
| Practice Location | |||||||||
| Address1: | 2350 MEADOWS BLVD | ||||||||
| Address2: | |||||||||
| City: | CASTLE ROCK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801098405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204553879 | ||||||||
| FaxNumber: | 7204550665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 07/15/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 26501 | CO | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 01265016 | 05 | CO | MEDICAID | 023777 | 01 | CO | KAISER COMMERCIAL NUMBER | OTHER |