Healthcare Provider Details

I. General information

NPI: 1366530404
Provider Name (Legal Business Name): DOCTORS MEDICAL GROUP OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 N ACADEMY BLVD STE 3
COLORADO SPRINGS CO
80917
US

IV. Provider business mailing address

3210 N ACADEMY BLVD STE 3
COLORADO SPRINGS CO
80917
US

V. Phone/Fax

Practice location:
  • Phone: 719-531-0409
  • Fax: 719-531-0410
Mailing address:
  • Phone: 719-531-0409
  • Fax: 719-531-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT KEITH SPEES
Title or Position: PHYSICIAN TREASURER
Credential: MD
Phone: 719-531-0409