Healthcare Provider Details

I. General information

NPI: 1871576512
Provider Name (Legal Business Name): ADVANCED GYNECOLOGY PROF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 SILVERSTONE TER STE 250
COLORADO SPRINGS CO
80919-3545
US

IV. Provider business mailing address

5731 SILVERSTONE TER STE 250
COLORADO SPRINGS CO
80919-3545
US

V. Phone/Fax

Practice location:
  • Phone: 719-633-8773
  • Fax: 719-633-1905
Mailing address:
  • Phone: 719-633-8773
  • Fax: 719-633-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROY C STRINGFELLOW
Title or Position: PRESIDENT
Credential: MD
Phone: 719-633-8773