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General NPI Number Information
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NPI Number | 1366530404
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Entity Type | Organization
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Legal Business Name | DOCTORS MEDICAL GROUP OF COLORADO
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 3210 N ACADEMY BLVD STE 3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917
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Country | US
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Telephone | 719-531-0409
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Fax | 719-531-0410
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Provider Business Mailing Address
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Address Line | 3210 N ACADEMY BLVD STE 3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917
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Country | US
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Telephone | 719-531-0409
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Fax | 719-531-0410
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Authorized Official
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Title or Position | PHYSICIAN TREASURER
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Name | DR. ROBERT KEITH SPEES
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Credential | MD
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Telephone | 719-531-0409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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