Provider Demographics
NPI:1912099599
Name:FRITZLER, STACE ANN (MD)
Entity type:Individual
Prefix:
First Name:STACE
Middle Name:ANN
Last Name:FRITZLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 S MASON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3740
Mailing Address - Country:US
Mailing Address - Phone:970-266-3600
Mailing Address - Fax:970-266-3629
Practice Address - Street 1:4601 S MASON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3740
Practice Address - Country:US
Practice Address - Phone:970-266-3600
Practice Address - Fax:970-266-3629
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01365519Medicaid
G59239Medicare UPIN
COC11854Medicare PIN