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NPI Code Detail

MEDICARE: COLORADO SPRINGS ALLERGY & ASTHMA CLINIC, PC

MEDICARE: COLORADO SPRINGS ALLERGY & ASTHMA CLINIC, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184731721
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLORADO SPRINGS ALLERGY & ASTHMA CLINIC, PC
Provider Business Mailing Address
First Line : 3425 AUSTIN BLUFFS PKWY
Second Line : SUITE 205
City : COLORADO SPRINGS
State : CO
Zip : 80918-5701
Country : US
Telephone Number : 719-592-1365
Fax Number : 719-592-1370
Provider Business Practice Location Address
First Line : 3425 AUSTIN BLUFFS PKWY
Second Line : SUITE 205
City : COLORADO SPRINGS
State : CO
Zip : 80918-5701
Country : US
Telephone Number : 719-592-1365
Fax Number : 719-592-1370
Authorized Official
Title or Position : OFFICE MANAGER
Name : MARTHA HARRELL
Credential :
Telephone Number : 719-592-1582
Provider Enumeration Date : 08/23/2006
Last Update Date : 10/05/2007

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Directions to “COLORADO SPRINGS ALLERGY & ASTHMA CLINIC, PC ” Practice Location

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