Healthcare Provider Details

I. General information

NPI: 1629193958
Provider Name (Legal Business Name): ALFRED C. SPEIRS M.D.,F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 W FILLMORE ST
COLORADO SPRINGS CO
80904-1166
US

IV. Provider business mailing address

1490 W FILLMORE ST
COLORADO SPRINGS CO
80904-1166
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-1300
  • Fax: 719-475-7944
Mailing address:
  • Phone: 719-475-1300
  • Fax: 719-475-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number15028
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: