| Pavilion Family Medicine | |
|
1804 E Pavilion Pl Montrose CO 81401-5795 | |
| (970) 249-6770 | |
| Not Available |
| Full Name | Pavilion Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1804 E Pavilion Pl, Montrose, Colorado |
| Authorized Official Name and Position | Corenna Howard (PRACTICE MANAGER) |
| Authorized Official Contact | 2073151595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pavilion Family Medicine 1804 E Pavilion Pl Montrose CO 81401-5795 Ph: (207) 315-1595 | Pavilion Family Medicine 1804 E Pavilion Pl Montrose CO 81401-5795 Ph: (970) 249-6770 |
| NPI Number | 1699214130 |
|---|---|
| Provider Enumeration Date | 02/16/2017 |
| Last Update Date | 12/13/2017 |
| Medicare PECOS PAC ID | 7517234164 |
|---|---|
| Medicare Enrollment ID | O20170601002403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699214130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DR 0057738 (Colorado) | Primary |
| Provider Name | John Ribadeneyra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689897753 PECOS PAC ID: 5890012017 Enrollment ID: I20170602000410 |
| Provider Name | Deanna L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023898699 PECOS PAC ID: 3678922002 Enrollment ID: I20231211003659 |
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