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General NPI Number Information
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NPI Number | 1003155185
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Entity Type | Organization
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Legal Business Name | SOUTHWEST HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 06/13/2017
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Provider Practice Location Address
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Address Line | 1280 N MILDRED RD SUITE 1
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City | CORTEZ
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State | CO
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Zip | 81321
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Country | US
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Telephone | 970-565-8336
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Fax | 970-565-3134
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Provider Business Mailing Address
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Address Line | 1311 N MILDRED ROAD
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City | CORTEZ
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State | CO
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Zip | 81321
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Country | US
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Telephone | 970-564-2152
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Fax | 970-564-2155
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM KENT ROGERS
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Credential |
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Telephone | 970-564-2150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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