Full Name | |
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Speciality | Family Medicine |
Location | 1211 Luther Street, Eads, Colorado |
Authorized Official Name and Position | Warren Yule (ADMINISTRATOR) |
Authorized Official Contact | 7194382251 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1211 Luther Street Po Box 7 Eads CO 81036 Ph: (719) 438-2251 | 1211 Luther Street Eads CO 81036 Ph: (719) 438-2251 |
NPI Number | 1265695993 |
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Provider Enumeration Date | 07/02/2008 |
Last Update Date | 07/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265695993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |