Provider Demographics
NPI:1265172464
Name:WALENTINE, COLLIN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:RICHARD
Last Name:WALENTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2422
Mailing Address - Fax:970-490-4155
Practice Address - Street 1:16990 VILLAGE CENTER DR E
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9376
Practice Address - Country:US
Practice Address - Phone:720-516-9191
Practice Address - Fax:720-516-9192
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0073718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program