Dr Cory Lynn Dietz, MD | |
700 W Us Highway 24, Woodland Park, CO 80863-8975 | |
(719) 522-1133 | |
Not Available |
Full Name | Dr Cory Lynn Dietz |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 700 W Us Highway 24, Woodland Park, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508825753 | NPI | - | NPPES |
3064089 | Medicaid | IA | |
28530250 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 28289 (Iowa) | Secondary |
207Q00000X | Family Medicine | DR.0053528 (Colorado) | Primary |
Entity Name | Poudre Valley Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366763260 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
Entity Name | Optumcare Colorado Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407252828 PECOS PAC ID: 2769706431 Enrollment ID: O20150129000413 |
Entity Name | Plushcare Of California Inc A Professional Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811378987 PECOS PAC ID: 2365707163 Enrollment ID: O20210824003650 |
Mailing Address | Practice Location Address |
---|---|
Dr Cory Lynn Dietz, MD 2 S Cascade Ave Ste 140, Colorado Springs, CO 80903-1604 Ph: (719) 538-2900 | Dr Cory Lynn Dietz, MD 700 W Us Highway 24, Woodland Park, CO 80863-8975 Ph: (719) 522-1133 |
Randolph Lee James, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 403 S Baldwin Street, Woodland Park, CO 80863 Phone: 719-686-7776 Fax: 719-355-1927 | |
Anne Frailing, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 700 W Us Highway 24, Woodland Park, CO 80863 Phone: 719-522-1133 | |
Michael E Kinne, NP Family Medicine Medicare: Medicare Enrolled Practice Location: 818 Misty Pines Cir, Woodland Park, CO 80863 Phone: 719-351-9767 | |
Dr. John R. Torrent, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 16222 W Us Highway 24 Ste 200, Woodland Park, CO 80863 Phone: 719-686-0878 Fax: 719-686-7331 | |
Nathaniel Fortner Lee, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 16222 W Us Highway 24 Ste 200, Woodland Park, CO 80863 Phone: 719-686-0878 Fax: 719-365-7885 | |
Muthanna Yacoub, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16222 W Us Highway 24 Ste 200, Woodland Park, CO 80863 Phone: 719-686-0878 Fax: 719-365-7885 |