| Sfph Sport Fam Med Ph | |
|
4925 N Nevada Ave Colorado Springs CO 80918-8600 | |
| (719) 776-4925 | |
| (719) 776-4926 |
| Full Name | Sfph Sport Fam Med Ph |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 4925 N Nevada Ave, Colorado Springs, Colorado |
| Authorized Official Name and Position | Angela Jo Skinner (ADMINISTRATOR, OMA) |
| Authorized Official Contact | 7206677283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sfph Sport Fam Med Ph Po Box 800022 Kansas City MO 64180-0022 Ph: (800) 953-0104 | Sfph Sport Fam Med Ph 4925 N Nevada Ave Colorado Springs CO 80918-8600 Ph: (719) 776-4925 |
| NPI Number | 1356980940 |
|---|---|
| Provider Enumeration Date | 12/30/2019 |
| Last Update Date | 07/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356980940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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