Healthcare Provider Details

I. General information

NPI: 1497086748
Provider Name (Legal Business Name): ROCKY MOUNTAIN FAMILY MEDICAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 08/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 STAFFORD LN
DELTA CO
81416-2282
US

IV. Provider business mailing address

PO BOX 1129
DELTA CO
81416-1129
US

V. Phone/Fax

Practice location:
  • Phone: 970-399-2880
  • Fax: 970-399-2848
Mailing address:
  • Phone: 970-874-2470
  • Fax: 970-874-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46365
License Number StateCO

VIII. Authorized Official

Name: ROBERT E BELL
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 970-399-2880