Basic Information
| Provider Information | |||||||||
| NPI: | 1528389368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEDGES | ||||||||
| FirstName: | CAROLINE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 S UNION BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809103147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196341532 | ||||||||
| FaxNumber: | 7196341715 | ||||||||
| Practice Location | |||||||||
| Address1: | 265 S PARKSIDE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809103140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196338773 | ||||||||
| FaxNumber: | 7196331905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2010 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TL-3594 | CO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | DR0052796 | CO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 80206778 | 05 | CO | MEDICAID |