Healthcare Provider Details

I. General information

NPI: 1801400189
Provider Name (Legal Business Name): EMERGENCY MEDICAL SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCHEALTH GRANDVIEW HOSPITAL - APP 5623 PULPIT PEAK VIEW
COLORADO SPRINGS CO
80918-3954
US

IV. Provider business mailing address

PO BOX 173891
DENVER CO
80217-3891
US

V. Phone/Fax

Practice location:
  • Phone: 719-272-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHY KAUP
Title or Position: OFFICE MANAGER
Credential:
Phone: 719-210-1814