Academy Dermatology Pc

NPI 1194162313 - Clinic/Center - 261QM2500X

NPI Details
NPI 1194162313
Enumeration Date 05/29/2013
Last Updated 05/29/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name RONALD A RONALD
Position PRESIDENT
Phone (719) 590-1800
Fax (719) 590-1858
Practice Location
1665 BRIARGATE BLVD
SUITE 200
COLORADO SPRINGS CO, 80920-3447, US
Phone (719) 590-1800
Fax (719) 590-1858
Business Location
1665 BRIARGATE BLVD
SUITE 200
COLORADO SPRINGS CO, 80920-3447, US
Phone (719) 590-1800
Fax (719) 590-1858
Toxanomy
Taxonomy Code 261QM2500X
License State Colorado
License Number 24691
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According to our database, Academy Dermatology Pc NPI is 1194162313, taxonomy code is 261QM2500X and license number is 24691, license state is located at Colorado. Academy Dermatology Pc physically located at 1665 Briargate Blvd, Colorado Springs CO, 80920-3447. NPI Number 1033115704 has the healthcare provider type.

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1194162313 NPI number is provided on an as is basis without warranty of any kind. 1194162313 is maintained by the National Plan & Provider Enumeration System. The contents of Academy Dermatology Pc are for informational purposes only.