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General NPI Number Information
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NPI Number | 1427159920
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Entity Type | Organization
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Legal Business Name | AFTER HOURS CLINIC OF FT MORGAN, LLC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 E BEAVER AVE
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City | FORT MORGAN
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State | CO
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Zip | 80701-3103
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Country | US
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Telephone | 970-867-2873
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Fax | 970-867-3439
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Provider Business Mailing Address
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Address Line | 220 E BEAVER AVE
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City | FORT MORGAN
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State | CO
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Zip | 80701-3103
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Country | US
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Telephone | 970-867-2873
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Fax | 970-867-3439
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN VIRGIL LINDELL
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Credential | M.D.
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Telephone | 970-867-2873
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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 | 24719
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License Number State | CO
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