Healthcare Provider Details

I. General information

NPI: 1598008492
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF GREELEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 W 16TH ST
GREELEY CO
80634-4902
US

IV. Provider business mailing address

6801 W 20TH ST SUITE 101
GREELEY CO
80634-9637
US

V. Phone/Fax

Practice location:
  • Phone: 970-356-2520
  • Fax: 970-356-6928
Mailing address:
  • Phone: 970-378-8000
  • Fax: 970-378-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. KYLE JON LYNCH
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 970-378-8000