Justin Banghart, PHYSICIAN ASSISTANT is a
Physician Assistant based in Pafb, Colorado. Justin Banghart is licensed to practice in * (Not Available) (license number 1164974) and his current practice location is
21st Mdg 559 Vincent St, Pafb, Colorado. He can be reached at his office (for appointments etc.) via phone at
(719) 556-5898.
NPI number for Justin Banghart is 1346888088 and his current mailing address is 559 Vinvent St, Peterson Space Force Base, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346888088.
Provider's Profile
| Full Name | Justin Banghart |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 21st Mdg 559 Vincent St, Pafb, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346888088
- Provider Enumeration Date: 12/12/2019
- Last Update Date: 06/30/2022
Medical Identifiers
Medical identifiers for Justin Banghart such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346888088 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 1164974 (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Banghart is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Banghart, PHYSICIAN ASSISTANT
559 Vinvent St,
Peterson Space Force Base, CO 80914
Ph: (719) 556-7019 | Justin Banghart, PHYSICIAN ASSISTANT
21st Mdg 559 Vincent St,
Pafb, CO 80914-1540
Ph: (719) 556-5898 |
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