| Foxtrail Family Medicine | |
|
1625 Foxtrail Dr Ste 190 Loveland CO 80538-9088 | |
| (970) 619-6900 | |
| (970) 619-6990 |
| Full Name | Foxtrail Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1625 Foxtrail Dr, Loveland, Colorado |
| Authorized Official Name and Position | Stephanie Doughty (CFO) |
| Authorized Official Contact | 9702377003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foxtrail Family Medicine 2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-8702 Ph: () - | Foxtrail Family Medicine 1625 Foxtrail Dr Ste 190 Loveland CO 80538-9088 Ph: (970) 619-6900 |
| NPI Number | 1407012826 |
|---|---|
| Provider Enumeration Date | 08/05/2008 |
| Last Update Date | 01/14/2014 |
| Medicare PECOS PAC ID | 6305994609 |
|---|---|
| Medicare Enrollment ID | O20090424000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407012826 | NPI | - | NPPES |
| 92181031 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ann Davies |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194841759 PECOS PAC ID: 5991870685 Enrollment ID: I20080814000336 |
| Provider Name | Anne I Siple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336155969 PECOS PAC ID: 3173527033 Enrollment ID: I20090428000109 |
| Provider Name | Deric C Mcintosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942468129 PECOS PAC ID: 0042486151 Enrollment ID: I20111220000418 |
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