| Academy Park Family Practice, Pc | |
|
7373 W Jefferson Ave Suite 201 Lakewood CO 80235-2038 | |
| (303) 979-1559 | |
| (303) 986-6895 |
| Full Name | Academy Park Family Practice, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7373 W Jefferson Ave, Lakewood, Colorado |
| Authorized Official Name and Position | Scott M Green (OWNER) |
| Authorized Official Contact | 3039791559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Academy Park Family Practice, Pc 7373 W Jefferson Ave Suite 201 Lakewood CO 80235-2038 Ph: (303) 979-1559 | Academy Park Family Practice, Pc 7373 W Jefferson Ave Suite 201 Lakewood CO 80235-2038 Ph: (303) 979-1559 |
| NPI Number | 1144377300 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6901969542 |
|---|---|
| Medicare Enrollment ID | O20090108000468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144377300 | NPI | - | NPPES |
| 1801877519 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 29123 (Colorado) | Primary |
| Provider Name | Scott M Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801877519 PECOS PAC ID: 6002702933 Enrollment ID: I20040226000383 |
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