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General NPI Number Information
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NPI Number | 1992609010
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MEDICAL AND PSYCHIATRIC CARE
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 538 BREEZE ST
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City | CRAIG
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State | CO
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Zip | 81625-2602
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Country | US
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Telephone | 970-761-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 538 BREEZE ST
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City | CRAIG
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State | CO
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Zip | 81625-2602
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Country | US
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Telephone | 970-761-9211
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | TAYLOR THRAILKILL
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Credential |
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Telephone | 970-216-2396
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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 |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | NULL
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