| Southern Colorado Family Medicine | |
|
902 Lakeview Ave Pueblo CO 81004-3597 | |
| (719) 557-5855 | |
| (719) 557-4652 |
| Full Name | Southern Colorado Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 902 Lakeview Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Angela Skinner (OMA ADMINISTRATOR) |
| Authorized Official Contact | 3036737175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Colorado Family Medicine Po Box 911057 Denver CO 80291-1057 Ph: (303) 643-1099 | Southern Colorado Family Medicine 902 Lakeview Ave Pueblo CO 81004-3597 Ph: (719) 557-5855 |
| NPI Number | 1710933163 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 04/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710933163 | NPI | - | NPPES |
| 49735578 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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