| Canon Professional, L.l.c. | |
|
730 Macon Ave Canon City CO 81212-3314 | |
| (719) 275-1618 | |
| (719) 275-7334 |
| Full Name | Canon Professional, L.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 730 Macon Ave, Canon City, Colorado |
| Authorized Official Name and Position | Gary Alan Mohr (OWNER) |
| Authorized Official Contact | 7192751618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canon Professional, L.l.c. 730 Macon Ave Canon City CO 81212-3314 Ph: (719) 275-1618 | Canon Professional, L.l.c. 730 Macon Ave Canon City CO 81212-3314 Ph: (719) 275-1618 |
| NPI Number | 1568625549 |
|---|---|
| Provider Enumeration Date | 07/09/2008 |
| Last Update Date | 07/09/2008 |
| Medicare PECOS PAC ID | 9931260726 |
|---|---|
| Medicare Enrollment ID | O20081211000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568625549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 24731 (Colorado) | Primary |
| Provider Name | Gary A Mohr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659481836 PECOS PAC ID: 0648331439 Enrollment ID: I20081215000791 |
| Provider Name | Sheila Repka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497323620 PECOS PAC ID: 0345630687 Enrollment ID: I20211201000975 |
| Provider Name | Leslie Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720721251 PECOS PAC ID: 2264813658 Enrollment ID: I20220716000042 |
Desert River Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 712 Macon Ave, Canon City, CO 81212 Phone: 719-285-8890 | |
Ncaldwell Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, Canon City, CO 81212 Phone: 702-453-3799 Fax: 702-453-5741 | |
James F. Reppert, M.d. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1335 Phay Ave Ste A, Canon City, CO 81212 Phone: 719-275-4151 Fax: 719-275-3743 | |
Colorado Mountain Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 115 S 7th St Ste 112, Canon City, CO 81212 Phone: 719-299-0988 | |
Rocky Mountain Clinics Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 Main St, Canon City, CO 81212 Phone: 209-309-1885 | |
Button Family Practice Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 715 South 9th Street, Canon City, CO 81212 Phone: 719-269-8820 Fax: 719-204-0230 | |
Marc A. Sindler, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 N 5th St, Canon City, CO 81212 Phone: 719-275-4137 |