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General NPI Number Information
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NPI Number | 1053489021
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Entity Type | Organization
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Legal Business Name | SOUTH SUBURBAN FAMILY MEDICINE
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 7720 S BROADWAY STE 480
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City | LITTLETON
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State | CO
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Zip | 80122-2600
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Country | US
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Telephone | 303-346-9490
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Fax | 303-346-9309
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Provider Business Mailing Address
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Address Line | 7720 S BROADWAY STE 480
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City | LITTLETON
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State | CO
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Zip | 80122-2600
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Country | US
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Telephone | 303-346-9490
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Fax | 303-346-9309
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JEFFRY N. GERBER
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Credential | M.D.
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Telephone | 303-346-9490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 32322
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License Number State | CO
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