| Family Medicine Clinic | |
|
100 W 4th St Walsenburg CO 81089-1910 | |
| (719) 738-1164 | |
| (719) 738-3399 |
| Full Name | Family Medicine Clinic |
|---|---|
| Speciality | General Practice |
| Location | 100 W 4th St, Walsenburg, Colorado |
| Authorized Official Name and Position | C David Neece (OWNER/PROVIDER) |
| Authorized Official Contact | 7197381164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Clinic 100 W 4th St Walsenburg CO 81089-1910 Ph: (719) 738-1164 | Family Medicine Clinic 100 W 4th St Walsenburg CO 81089-1910 Ph: (719) 738-1164 |
| NPI Number | 1760675698 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760675698 | NPI | - | NPPES |
| C444298 | Other | CO | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 27053 (Colorado) | Primary |
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