Healthcare Provider Details
I. General information
NPI: 1124632765
Provider Name (Legal Business Name): PEAK MEDICAL CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5623 PULPIT PEAK VW
COLORADO SPRINGS CO
80918-3954
US
IV. Provider business mailing address
PO BOX 17503
DENVER CO
80217-0503
US
V. Phone/Fax
- Phone: 719-884-2000
- Fax:
- Phone: 719-884-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGE
LOUIS
HERTNER
Title or Position: AO
Credential: MD
Phone: 719-884-2000