MEDICARE: SCOTT BRASSFIELD MD 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	CO22644	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	22644	OTHER	CO	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1740426170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT BRASSFIELD MD PC

Provider Business Mailing Address
First Line	:	3220 N ACADEMY BLVD
Second Line	:	5
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-5115
Country	:	US
Telephone Number	:	719-574-3600
Fax Number	:	719-574-1686

Provider Business Practice Location Address
First Line	:	3220 N ACADEMY BLVD
Second Line	:	5
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-5115
Country	:	US
Telephone Number	:	719-574-3600
Fax Number	:	719-574-1686

Authorized Official
Title or Position	:	PHYSICIANS
Name	:	DR. SCOTT BRASSFIELD
Credential	:	MD
Telephone Number	:	719-574-3600

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	05/19/2010

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Directions to “SCOTT BRASSFIELD MD PC ” Practice Location

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