| Alliance Family Practice | |
|
9320 Grand Cordera Pkwy Suite 100 Colorado Springs CO 80924-7003 | |
| (719) 282-6337 | |
| (719) 282-0532 |
| Full Name | Alliance Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 9320 Grand Cordera Pkwy, Colorado Springs, Colorado |
| Authorized Official Name and Position | Mark Philp Carroll (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7192826337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Family Practice 9320 Grand Cordera Pkwy Suite 100 Colorado Springs CO 80924-7003 Ph: (719) 282-6337 | Alliance Family Practice 9320 Grand Cordera Pkwy Suite 100 Colorado Springs CO 80924-7003 Ph: (719) 282-6337 |
| NPI Number | 1326253436 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 01/15/2014 |
| Medicare PECOS PAC ID | 1759482292 |
|---|---|
| Medicare Enrollment ID | O20070727000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326253436 | NPI | - | NPPES |
| Provider Name | Mark P Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437121597 PECOS PAC ID: 6204936362 Enrollment ID: I20070703000346 |
| Provider Name | Sara Elizabeth Charnecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104879766 PECOS PAC ID: 9234181975 Enrollment ID: I20110629000340 |
| Provider Name | Luis E Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730143827 PECOS PAC ID: 2264694660 Enrollment ID: I20120501000581 |
| Provider Name | Jeremy E Jarecke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588821060 PECOS PAC ID: 3375794068 Enrollment ID: I20121106000057 |
| Provider Name | Steven J Edginton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598064842 PECOS PAC ID: 9830361419 Enrollment ID: I20130521000209 |
| Provider Name | Katelyn Dakota Jae Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497316657 PECOS PAC ID: 1153658778 Enrollment ID: I20221012000240 |
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