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General NPI Number Information
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NPI Number | 1720736937
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 688 23 1/2 RD STE 101
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-8904
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Country | US
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Telephone | 970-623-8860
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Fax | 970-623-8869
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Provider Business Mailing Address
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Address Line | PO BOX 1727
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City | GRAND JCT
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State | CO
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Zip | 81502-1727
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Country | US
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Telephone | 970-257-6200
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Fax | 970-263-2691
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | CHRISTIAN THOMAS
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Credential |
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Telephone | 970-623-5265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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