| Prairie Medical Clinic Pllc | |
|
1726 S Prairie Ave Pueblo CO 81005-2253 | |
| (719) 561-8660 | |
| (719) 561-8660 |
| Full Name | Prairie Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1726 S Prairie Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Benjamin Martinez (PHYSICIAN) |
| Authorized Official Contact | 7195611291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Medical Clinic Pllc 1726 S Prairie Ave Pueblo CO 81005-2253 Ph: (719) 561-8660 | Prairie Medical Clinic Pllc 1726 S Prairie Ave Pueblo CO 81005-2253 Ph: (719) 561-8660 |
| NPI Number | 1891914693 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891914693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Colorado) | Primary |
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