| |
70 S 20th Ave Suite H Brighton CO 80601-3703 | |
(303) 655-1111 | |
(303) 655-1172 |
Full Name | |
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Speciality | Family Medicine |
Location | 70 S 20th Ave, Brighton, Colorado |
Authorized Official Name and Position | Warren T Johnson (CEO) |
Authorized Official Contact | 3036551111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
70 S 20th Ave Suite H Brighton CO 80601-3703 Ph: (303) 655-1111 | 70 S 20th Ave Suite H Brighton CO 80601-3703 Ph: (303) 655-1111 |
NPI Number | 1801236948 |
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Provider Enumeration Date | 07/03/2013 |
Last Update Date | 07/03/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801236948 | NPI | - | NPPES |
01248277 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 24827 (Colorado) | Primary |
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