| Theodore | |
|
1619 N Greenwood St Ste 208 Pueblo CO 81003-2656 | |
| (719) 561-4336 | |
| (719) 561-8469 |
| Full Name | Theodore |
|---|---|
| Speciality | Family Medicine |
| Location | 1619 N Greenwood St Ste 208, Pueblo, Colorado |
| Authorized Official Name and Position | Ted J Puls (MD) |
| Authorized Official Contact | 7195614336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore 1619 N Greenwood St Ste 208 Pueblo CO 81003-2656 Ph: (719) 561-4336 | Theodore 1619 N Greenwood St Ste 208 Pueblo CO 81003-2656 Ph: (719) 561-4336 |
| NPI Number | 1245283134 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 11/08/2023 |
| Medicare PECOS PAC ID | 5294703831 |
|---|---|
| Medicare Enrollment ID | O20040921000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245283134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Theodore J Puls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588643290 PECOS PAC ID: 2466443791 Enrollment ID: I20040524000982 |
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