MEDICARE: COLUMBINE WOMEN'S CLINIC

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	207VG0400X	Gynecology Physician	35152	CO

General Provider Information

NPI Number	:	1114988458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBINE WOMEN'S CLINIC

Provider Business Mailing Address
First Line	:	PO BOX 1418
Second Line	:
City	:	FT COLLINS
State	:	CO
Zip	:	80522-1418
Country	:	US
Telephone Number	:	970-225-6100
Fax Number	:	970-225-6102

Provider Business Practice Location Address
First Line	:	1020 LUKE ST
Second Line	:	STE. A
City	:	FT COLLINS
State	:	CO
Zip	:	80524-4016
Country	:	US
Telephone Number	:	970-225-6100
Fax Number	:	970-225-6102

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN E FRANCO
Credential	:	M.D.
Telephone Number	:	970-225-6100

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/22/2020

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