MEDICARE: INTEGRITY FAMILY HEALTHCARE PC

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	207Q00000X	Family Medicine Physician	27696	CO

General Provider Information

NPI Number	:	1417161589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY FAMILY HEALTHCARE PC

Provider Business Mailing Address
First Line	:	1465 KELLY JOHNSON BLVD
Second Line	:	SUITE 100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3955
Country	:	US
Telephone Number	:	719-572-0951
Fax Number	:	719-572-0955

Provider Business Practice Location Address
First Line	:	1465 KELLY JOHNSON BLVD
Second Line	:	SUITE 100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3955
Country	:	US
Telephone Number	:	719-572-0951
Fax Number	:	719-572-0955

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRIAN OLIVIER
Credential	:	M.D.
Telephone Number	:	719-572-0951

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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