MEDICARE: PIKES PEAK ANESTHESIA ASSOCIATES P.C.

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1710091186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIKES PEAK ANESTHESIA ASSOCIATES P.C.

Provider Business Mailing Address
First Line	:	PO BOX 820
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80901-0820
Country	:	US
Telephone Number	:	719-448-0981
Fax Number	:	719-448-0767

Provider Business Practice Location Address
First Line	:	15 S WEBER ST
Second Line	:	SUITE B
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1902
Country	:	US
Telephone Number	:	719-448-0981
Fax Number	:	719-448-0767

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES H RIPP
Credential	:	M.D.
Telephone Number	:	719-448-0981

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	10/26/2007

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