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General NPI Number Information
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NPI Number | 1861436503
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Entity Type | Individual
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Provider Name | GARY ANDREW TARSHIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 2141 N ACADEMY CIRCLE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1672
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Country | US
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Telephone | 719-597-4200
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Fax | 719-597-4495
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Provider Business Mailing Address
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Address Line | 2141 N ACADEMY CIRCLE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1672
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Country | US
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Telephone | 719-597-4200
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Fax | 719-597-4495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29971
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License Number State | CO
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