MEDICARE: DR. KEVIN E BACHUS MD

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	27514	CO
2	207VE0102X	Reproductive Endocrinology Physician	27514	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	27514	OTHER	CO	STATE LICENSE

General Provider Information

NPI Number	:	1689671539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN E BACHUS MD

Provider Business Mailing Address
First Line	:	1080 E ELIZABETH ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3953
Country	:	US
Telephone Number	:	970-493-6353
Fax Number	:	970-493-6366

Provider Business Practice Location Address
First Line	:	1080 E ELIZABETH ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3953
Country	:	US
Telephone Number	:	970-493-6353
Fax Number	:	970-493-6366

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/14/2021

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Directions to “ DR. KEVIN E BACHUS MD” Practice Location

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