MEDICARE: SARAH B FELT DO

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39953	CO

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00231963	OTHER		TRAVELERS MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	840706945	OTHER	CO	ROCKY MOUNTAIN HEATLH PLA
4	FE668556	OTHER	CO	ANTHEM BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1396733457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH B FELT DO

Provider Business Mailing Address
First Line	:	916 INDIANA AVE
Second Line	:	SUITE 120
City	:	PUEBLO
State	:	CO
Zip	:	81004-3572
Country	:	US
Telephone Number	:	719-562-1122
Fax Number	:	719-562-0244

Provider Business Practice Location Address
First Line	:	916 INDIANA AVE
Second Line	:	SUITE 120
City	:	PUEBLO
State	:	CO
Zip	:	81004-3572
Country	:	US
Telephone Number	:	719-562-1122
Fax Number	:	719-562-0244

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	05/05/2008

916 INDIANA AVE , STE 110
PUEBLO, CO
81004-3572

Practice Phone: 719-566-9120
Practice Fax: 719-566-9121

916 INDIANA AVE STE 120
PUEBLO, CO
81004-3572