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General NPI Number Information
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NPI Number | 1750578423
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Entity Type | Organization
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Legal Business Name | SOUTH SUBURBAN FAMILY PRACTICE P C
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 7180 E ORCHARD RD STE 101
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City | CENTENNIAL
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State | CO
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Zip | 80111-1725
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Country | US
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Telephone | 303-721-0220
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Fax | 303-771-8560
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Provider Business Mailing Address
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Address Line | 7180 E ORCHARD RD STE 101
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City | CENTENNIAL
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State | CO
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Zip | 80111-1725
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Country | US
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Telephone | 303-721-0220
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Fax | 303-771-8560
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER JOHN VERKLER
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Credential | M.D.
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Telephone | 303-721-0220
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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 | 26985
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License Number State | CO
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