| Haxtun Family Medicine Center | |
|
235 W Fletcher Haxtun CO 80731-2737 | |
| (970) 774-6123 | |
| (970) 774-6158 |
| Full Name | Haxtun Family Medicine Center |
|---|---|
| Speciality | Family Medicine |
| Location | 235 W Fletcher, Haxtun, Colorado |
| Authorized Official Name and Position | Donald Burris (CEO) |
| Authorized Official Contact | 9707746123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Haxtun Family Medicine Center 235 W Fletcher Haxtun CO 80731-2737 Ph: (970) 774-6123 | Haxtun Family Medicine Center 235 W Fletcher Haxtun CO 80731-2737 Ph: (970) 774-6123 |
| NPI Number | 1134185903 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 06/29/2011 |
| Medicare PECOS PAC ID | 5496664567 |
|---|---|
| Medicare Enrollment ID | O20040310000999 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134185903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nathaniel Silas Chappelle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194160077 PECOS PAC ID: 6507160322 Enrollment ID: I20180403002766 |
| Provider Name | Jessica Bullard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316574148 PECOS PAC ID: 6901212844 Enrollment ID: I20210301002506 |
| Provider Name | Benjamin D Stephenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679771414 PECOS PAC ID: 1658565551 Enrollment ID: I20210303000811 |
| Provider Name | Amy L Seinfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942281142 PECOS PAC ID: 5294626917 Enrollment ID: I20210520002927 |
| Provider Name | Jodi Desiree' Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548722655 PECOS PAC ID: 1355675596 Enrollment ID: I20220317001370 |
Banner Health Physicians Colorado Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 235 W Fletcher St, Haxtun, CO 80731 Phone: 970-774-6123 Fax: 970-774-6158 |