MEDICARE: FAMILY PRACTICE ASSOCIATES 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
1	207Q00000X	Family Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1952593873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PRACTICE ASSOCIATES PC

Provider Business Mailing Address
First Line	:	433 SUMMIT BLVD UNIT 201
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8299
Country	:	US
Telephone Number	:	303-673-9090
Fax Number	:	303-673-9195

Provider Business Practice Location Address
First Line	:	433 SUMMIT BLVD UNIT 201
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8299
Country	:	US
Telephone Number	:	303-673-9090
Fax Number	:	303-673-9195

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ANGIE MARTIN
Credential	:
Telephone Number	:	303-673-9090

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	03/06/2020

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