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NPI Code Detail

MEDICARE: KELBY F BETHARDS MD

MEDICARE:   KELBY F BETHARDS  MD
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
1207Q00000XFamily Medicine Physician39770CO

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 : 1588643894
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELBY F BETHARDS MD
Provider Business Mailing Address
First Line : 2127 E HARMONY RD
Second Line : STE 140
City : FORT COLLINS
State : CO
Zip : 80528-3406
Country : US
Telephone Number : 970-297-6250
Fax Number : 970-297-6260
Provider Business Practice Location Address
First Line : 2127 E HARMONY RD
Second Line : STE 140
City : FORT COLLINS
State : CO
Zip : 80528-3406
Country : US
Telephone Number : 970-297-6250
Fax Number : 970-297-6260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 06/12/2014

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Directions to “ KELBY F BETHARDS MD” Practice Location

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