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General NPI Number Information
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NPI Number | 1114944121
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Entity Type | Organization
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Legal Business Name | SOUTHEAST FAMILY PHYSICIANS
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 10099 RIDGEGATE PKWY SUITE 340
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City | LONE TREE
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State | CO
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Zip | 80124-5531
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Country | US
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Telephone | 303-706-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 3464 S WILLOW ST SUITE 376
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City | DENVER
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State | CO
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Zip | 80231-4531
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Country | US
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Telephone | 303-755-2900
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Fax | 303-755-0404
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | SUSAN PASH-LOHR
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Credential | MD
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Telephone | 303-706-0400
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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 |
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License Number State |
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