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General NPI Number Information
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NPI Number | 1447395553
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Entity Type | Organization
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Legal Business Name | SADDLE ROCK FAMILY PRACTICE PC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 11/13/2009
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Provider Practice Location Address
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Address Line | 19641 E PARKER SQUARE DR SUITE A
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City | PARKER
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State | CO
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Zip | 80134-7399
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Country | US
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Telephone | 303-406-0080
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Fax | 303-805-7289
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Provider Business Mailing Address
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Address Line | 19641 E PARKER SQUARE DR SUITE A
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City | PARKER
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State | CO
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Zip | 80134-7399
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Country | US
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Telephone | 303-406-0080
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Fax | 303-805-7289
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Authorized Official
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Title or Position | FRONT DESK LEAD
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Name | KRISTIN JACOBS
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Credential |
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Telephone | 303-406-0080
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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 | 927
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License Number State | CO
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