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NPI Code Detail

MEDICARE: FRONT RANGE URGENT CARE, INC.

MEDICARE: FRONT RANGE URGENT CARE, INC.
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 Physician
2261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699319590
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRONT RANGE URGENT CARE, INC.
Provider Business Mailing Address
First Line : 5799 STETSON HILLS BLVD STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-4223
Country : US
Telephone Number : 719-471-2273
Fax Number :
Provider Business Practice Location Address
First Line : 6530 S ACADEMY BLVD STE 105
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-8635
Country : US
Telephone Number : 719-471-2273
Fax Number : 719-325-8954
Authorized Official
Title or Position : OWNER
Name : ANITA WIESCAMP
Credential :
Telephone Number : 719-510-0957
Provider Enumeration Date : 11/04/2019
Last Update Date : 08/30/2023

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Directions to “FRONT RANGE URGENT CARE, INC. ” Practice Location

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