MEDICARE: DR. GREGORY FRANKLIN BLAND M.D.

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
1	208200000X	Plastic Surgery Physician	33406	CO

General Provider Information

NPI Number	:	1598767378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY FRANKLIN BLAND M.D.

Provider Business Mailing Address
First Line	:	3920 N UNION BLVD
Second Line	:	SUITE 300
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4900
Country	:	US
Telephone Number	:	719-634-0107
Fax Number	:	719-634-5832

Provider Business Practice Location Address
First Line	:	3920 N UNION BLVD
Second Line	:	SUITE 300
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4900
Country	:	US
Telephone Number	:	719-634-0107
Fax Number	:	719-634-5832

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

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