| Aspen Leaf Internal Medicine, P.c. | |
|
751 Horizon Ct Ste 202 Grand Junction CO 81506-8718 | |
| (970) 242-4145 | |
| (970) 242-4134 |
| Full Name | Aspen Leaf Internal Medicine, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 751 Horizon Ct Ste 202, Grand Junction, Colorado |
| Authorized Official Name and Position | Kelly Ann King (PRESIDENT) |
| Authorized Official Contact | 9702424145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Leaf Internal Medicine, P.c. 751 Horizon Ct Ste 202 Grand Junction CO 81506-8718 Ph: (970) 242-4145 | Aspen Leaf Internal Medicine, P.c. 751 Horizon Ct Ste 202 Grand Junction CO 81506-8718 Ph: (970) 242-4145 |
| NPI Number | 1629260237 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 08/16/2007 |
| Medicare PECOS PAC ID | 6608763982 |
|---|---|
| Medicare Enrollment ID | O20040302000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629260237 | NPI | - | NPPES |
| 49959549 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 37446 (Colorado) | Primary |
| Provider Name | Kelly A King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558469106 PECOS PAC ID: 6204723588 Enrollment ID: I20090515000397 |
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