MEDICARE: PHYSICIANS OF COLORADO LLC

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	208M00000X	Hospitalist Physician	42607	CO

General Provider Information

NPI Number	:	1174824817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS OF COLORADO LLC

Provider Business Mailing Address
First Line	:	PO BOX 62302
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80962-2302
Country	:	US
Telephone Number	:	719-660-4132
Fax Number	:

Provider Business Practice Location Address
First Line	:	1085 WAR EAGLE DR N
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-1640
Country	:	US
Telephone Number	:	719-660-4132
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ROBERT JULES BARON
Credential	:	M.D.
Telephone Number	:	719-660-4132

Provider Enumeration Date	:	11/11/2010
Last Update Date	:	09/17/2013

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