Healthcare Provider Details

I. General information

NPI: 1396937660
Provider Name (Legal Business Name): COMPREHENSIVE FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6035 ERIN PARK DR STE 202
COLORADO SPRINGS CO
80918-3427
US

IV. Provider business mailing address

6035 ERIN PARK DR STE 202
COLORADO SPRINGS CO
80918-3427
US

V. Phone/Fax

Practice location:
  • Phone: 719-955-0250
  • Fax: 719-955-0250
Mailing address:
  • Phone: 719-955-0250
  • Fax: 719-631-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateCO

VIII. Authorized Official

Name: KENT ROBERSON
Title or Position: PHYSICIAN
Credential: MD
Phone: 719-955-2050