| Mountain Streams Medical Center Pc | |
|
2155 Hollow Brook Dr Ste 60 Colorado Springs CO 80918-1455 | |
| (719) 536-4831 | |
| (719) 536-4814 |
| Full Name | Mountain Streams Medical Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2155 Hollow Brook Dr Ste 60, Colorado Springs, Colorado |
| Authorized Official Name and Position | Scott B Woody (PRESIDENT) |
| Authorized Official Contact | 7193216974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Streams Medical Center Pc Po Box 820 Castle Rock CO 80104-0820 Ph: () - | Mountain Streams Medical Center Pc 2155 Hollow Brook Dr Ste 60 Colorado Springs CO 80918-1455 Ph: (719) 536-4831 |
| NPI Number | 1710046958 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 06/02/2020 |
| Medicare PECOS PAC ID | 2163422700 |
|---|---|
| Medicare Enrollment ID | O20070105000173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710046958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 39735 (Colorado) | Primary |
| Provider Name | Scott B Woody |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033117957 PECOS PAC ID: 5991617326 Enrollment ID: I20041117001076 |
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