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General NPI Number Information
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NPI Number | 1295807543
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Entity Type | Organization
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Legal Business Name | UNIVERSITY FAMILY MEDICINE CENTER, P.C.
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 4020 JERRY MURPHY RD
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City | PUEBLO
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State | CO
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Zip | 81001-1045
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Country | US
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Telephone | 719-546-3600
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Fax | 719-546-0931
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Provider Business Mailing Address
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Address Line | 4020 JERRY MURPHY RD
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City | PUEBLO
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State | CO
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Zip | 81001-1045
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Country | US
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Telephone | 719-546-3600
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Fax | 719-546-0931
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TAMMY J ESPINOZA
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Credential |
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Telephone | 719-546-3600
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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 | 30639
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27511
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License Number State | CO
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