| Agewell Medical Associates, Pc | |
|
2350 International Cir Colorado Springs CO 80910-3139 | |
| (719) 475-5065 | |
| (719) 475-5797 |
| Full Name | Agewell Medical Associates, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2350 International Cir, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jeffrey T Kulp (OWNER) |
| Authorized Official Contact | 7194755065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agewell Medical Associates, Pc 2350 International Cir Colorado Springs CO 80910-3139 Ph: (719) 475-5065 | Agewell Medical Associates, Pc 2350 International Cir Colorado Springs CO 80910-3139 Ph: (719) 475-5065 |
| NPI Number | 1144341959 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 07/30/2012 |
| Medicare PECOS PAC ID | 8527164466 |
|---|---|
| Medicare Enrollment ID | O20070509000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144341959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Elizabeth R Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245338284 PECOS PAC ID: 7416914056 Enrollment ID: I20041215000127 |
| Provider Name | Jeffrey T Kulp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972506053 PECOS PAC ID: 6305887506 Enrollment ID: I20070509000579 |
| Provider Name | Lisa Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780780098 PECOS PAC ID: 8123115763 Enrollment ID: I20071030000318 |
| Provider Name | Brad R Bingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861405425 PECOS PAC ID: 0749400711 Enrollment ID: I20140926000153 |
| Provider Name | Paula Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609979855 PECOS PAC ID: 0840246401 Enrollment ID: I20160324000157 |
| Provider Name | Elaine Catherine Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184605818 PECOS PAC ID: 1759374754 Enrollment ID: I20180404000282 |
| Provider Name | Fernando H Thadepalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821075821 PECOS PAC ID: 9537195326 Enrollment ID: I20180605002430 |
| Provider Name | Whitney Pahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750856951 PECOS PAC ID: 5890048342 Enrollment ID: I20181030002053 |
| Provider Name | Stephanie M Vanlandingham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336535228 PECOS PAC ID: 6901195445 Enrollment ID: I20190722003505 |
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