MEDICARE: DR. ROBERT CHARLES PRICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	46057	CO
2	207Q00000X	Family Medicine Physician	46057	CO

General Provider Information

NPI Number	:	1043233612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CHARLES PRICE MD

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:	706-244-0349
Fax Number	:	970-490-4347

Provider Business Practice Location Address
First Line	:	2767 JANITELL RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4102
Country	:	US
Telephone Number	:	719-365-2888
Fax Number	:	719-365-1577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	03/27/2018

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