Southwest Internal Medicine Pllc | |
111 N Park St Cortez CO 81321-3340 | |
(970) 564-8730 | |
Not Available |
Full Name | Southwest Internal Medicine Pllc |
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Speciality | Internal Medicine |
Location | 111 N Park St, Cortez, Colorado |
Authorized Official Name and Position | Erin Henderson (OWNER/AO) |
Authorized Official Contact | 9705648730 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southwest Internal Medicine Pllc 111 N Park St Cortez CO 81321-3340 Ph: (970) 564-8730 | Southwest Internal Medicine Pllc 111 N Park St Cortez CO 81321-3340 Ph: (970) 564-8730 |
NPI Number | 1083784060 |
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Provider Enumeration Date | 11/08/2006 |
Last Update Date | 06/22/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083784060 | NPI | - | NPPES |
98950886 | Medicaid | NM | |
18627269 | Medicaid | CO | |
798770 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |