| Optumcare Colorado Springs, Llc | |
| 
					5115 Fontaine Blvd Fountain CO 80817-1061  | |
| (719) 392-2000 | |
| (719) 392-6937 | 
| Full Name | Optumcare Colorado Springs, Llc | 
|---|---|
| Speciality | General Practice | 
| Location | 5115 Fontaine Blvd, Fountain, Colorado | 
| Authorized Official Name and Position | John G. Liethen (SECRETARY) | 
| Authorized Official Contact | 9522056262 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Optumcare Colorado Springs, Llc 2 S Cascade Ave Ste 140 Colorado Springs CO 80903-1624 Ph: (719) 538-2900  | Optumcare Colorado Springs, Llc 5115 Fontaine Blvd Fountain CO 80817-1061 Ph: (719) 392-2000  | 
| NPI Number | 1316480783 | 
|---|---|
| Provider Enumeration Date | 12/02/2016 | 
| Last Update Date | 08/20/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316480783 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary | 
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