| Dynamic Family Medicine Pllc | |
|
5715 Kittery Dr Colorado Springs CO 80911-3551 | |
| (719) 392-3883 | |
| (719) 390-6338 |
| Full Name | Dynamic Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5715 Kittery Dr, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jeremy Ronald Brown (OWNER/PHYSICIAN) |
| Authorized Official Contact | 7193923883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Family Medicine Pllc 5715 Kittery Dr Colorado Springs CO 80911-3551 Ph: (719) 392-3883 | Dynamic Family Medicine Pllc 5715 Kittery Dr Colorado Springs CO 80911-3551 Ph: (719) 392-3883 |
| NPI Number | 1639609894 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2163797796 |
|---|---|
| Medicare Enrollment ID | O20171009001105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639609894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeremy R Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912212093 PECOS PAC ID: 5496989410 Enrollment ID: I20131007000868 |
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