Healthcare Provider Details

I. General information

NPI: 1972604866
Provider Name (Legal Business Name): FALCON FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7641 MCLAUGHLIN RD
PEYTON CO
80831-4715
US

IV. Provider business mailing address

7641 MCLAUGHLIN RD
PEYTON CO
80831-4715
US

V. Phone/Fax

Practice location:
  • Phone: 719-494-2006
  • Fax: 719-494-8448
Mailing address:
  • Phone: 719-494-2006
  • Fax: 719-494-8448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCO

VIII. Authorized Official

Name: DR. KENT STEVEN HERBERT
Title or Position: OWNER
Credential: M.D.
Phone: 719-494-2006