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NPI Code Detail

MEDICARE: AMY J ARCHER DO

MEDICARE: AMY J ARCHER DO
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
1207Q00000XFamily Medicine Physician3991AZ
2207Q00000XFamily Medicine PhysicianDR.0055398CO

General Provider Information

NPI Number : 1205800208
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY J ARCHER DO
Provider Business Mailing Address
First Line : PO BOX 130
Second Line :
City : FRUITA
State : CO
Zip : 81521-0130
Country : US
Telephone Number : 970-858-9894
Fax Number : 970-858-1331
Provider Business Practice Location Address
First Line : 1905 BLAKE AVE STE 101
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4206
Country : US
Telephone Number : 970-945-2840
Fax Number : 970-945-2893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 04/03/2024

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