Healthcare Provider Details

I. General information

NPI: 1588606818
Provider Name (Legal Business Name): ROCKY MOUNTAIN NEUROPSYCHIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 TUTT BLVD STE 100
COLORADO SPRINGS CO
80923-3503
US

IV. Provider business mailing address

6160 TUTT BLVD STE 100
COLORADO SPRINGS CO
80923-3503
US

V. Phone/Fax

Practice location:
  • Phone: 719-473-2346
  • Fax: 719-577-9627
Mailing address:
  • Phone: 719-473-2346
  • Fax: 719-577-9627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD MARCINIAK
Title or Position: PRESIDENT
Credential: M.D,
Phone: 719-473-2346