Dr Stanley C Pense, MD | |
785 Russell St, Craig, CO 81625-2019 | |
(970) 826-2420 | |
(970) 826-2429 |
Full Name | Dr Stanley C Pense |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 785 Russell St, Craig, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255304903 | NPI | - | NPPES |
25424556 | Medicaid | CO | |
216417 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 23170 (Arizona) | Secondary |
208600000X | Surgery | 45100 (Colorado) | Primary |
Entity Name | South West Internal Medicine Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497203194 PECOS PAC ID: 1052691987 Enrollment ID: O20170313002271 |
Mailing Address | Practice Location Address |
---|---|
Dr Stanley C Pense, MD 785 Russell St, Craig, CO 81625-2019 Ph: (970) 826-2420 | Dr Stanley C Pense, MD 785 Russell St, Craig, CO 81625-2019 Ph: (970) 826-2420 |
Dana L Miller, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 750 Hospital Loop, Craig, CO 81625 Phone: 970-824-9411 Fax: 970-826-3116 | |
Dr. David Robert James, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 785 Russel Street, Suite 100, Craig, CO 81625 Phone: 970-824-5759 Fax: 970-826-0698 | |
Jeffrey P Womble, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 750 Hospital Loop, Craig, CO 81625 Phone: 970-826-2420 Fax: 970-826-2429 |