| Brandon R Black, MD | |
|
1619 N Greenwood St, Suite 103, Pueblo, CO 81003-2644 | |
| (719) 542-2167 | |
| (719) 542-0320 |
| Full Name | Brandon R Black |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 26 Years |
| Location | 1619 N Greenwood St, Pueblo, Colorado |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740249879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 2001015984 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkview Medical Center, Inc | Pueblo, CO | Hospital |
| Spanish Peaks Regional Health Center | Walsenburg, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Parkwest Imaging, L.l.c | 3173415247 | 10 |
| Southern Colorado Radiologists, P.c. | 7517959794 | 11 |
| Entity Name | Parkwest Imaging, L.l.c |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790730810 PECOS PAC ID: 3173415247 Enrollment ID: O20040325000949 |
| Entity Name | Southern Colorado Radiologists, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386699486 PECOS PAC ID: 7517959794 Enrollment ID: O20040330001136 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon R Black, MD 1619 N Greenwood St, Suite 103, Pueblo, CO 81003-2644 Ph: (719) 542-2167 | Brandon R Black, MD 1619 N Greenwood St, Suite 103, Pueblo, CO 81003-2644 Ph: (719) 542-2167 |
Dr. Michael J Mccollum, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1008 Minnequa Ave, Pueblo, CO 81004 Phone: 719-542-7891 | |
Krynn Louis Stegelmeier, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1619 N Greenwood St, Pueblo, CO 81003 Phone: 719-542-2167 | |
Geoffrey Eric Johnson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1008 Minnequa Ave, Pueblo, CO 81004 Phone: 719-557-5460 | |
Lisa T Cramer, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1619 N Greenwood St, Suite 103, Pueblo, CO 81003 Phone: 719-542-2167 Fax: 719-542-0320 | |
William J Bufkin, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 124 W Pitkin Ave, Pueblo, CO 81004 Phone: 719-584-7410 Fax: 719-542-7019 | |
Dr. Mark Fredric Abbott, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1619 N Greenwood St Ste 103, Pueblo, CO 81003 Phone: 719-542-2167 | |
Gordon F Gibbs, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 115 E Riverwalk, Unit 200, Pueblo, CO 81003 Phone: 719-542-7891 |