Provider Demographics
NPI:1679604581
Name:HUGH HOLLEMAN MACAULAY, III, MD, PC
Entity type:Organization
Organization Name:HUGH HOLLEMAN MACAULAY, III, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:H
Authorized Official - Last Name:MACAULAY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD, ABFP, ABEM
Authorized Official - Phone:303-807-8457
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-1245
Mailing Address - Country:US
Mailing Address - Phone:303-807-8457
Mailing Address - Fax:303-722-0613
Practice Address - Street 1:23295 OEHLMANN PARK RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-4500
Practice Address - Country:US
Practice Address - Phone:303-807-8457
Practice Address - Fax:303-722-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28626305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
COM40142Medicare UPIN