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General NPI Number Information
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NPI Number | 1033292214
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Entity Type | Organization
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Legal Business Name | PIKES PEAK ENDOSCOPY AND SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 1699 MEDICAL CENTER PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-5700
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Country | US
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Telephone | 719-632-7101
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Fax | 719-632-4468
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Provider Business Mailing Address
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Address Line | 1699 MEDICAL CENTER PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-5700
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Country | US
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Telephone | 719-632-7101
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Fax | 719-632-4468
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Authorized Official
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Title or Position | PARTNER
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Name | SUE M MITCHELL
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Credential | MD
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Telephone | 719-632-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0108
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License Number State | CO
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