| Front Range Preventive Imaging | |
|
2880 Folsom St Suite 100 Boulder CO 80304-3769 | |
| (303) 443-7226 | |
| (303) 443-7168 |
| Full Name | Front Range Preventive Imaging |
|---|---|
| Speciality | Internal Medicine |
| Location | 2880 Folsom St, Boulder, Colorado |
| Authorized Official Name and Position | William Lawson Blanchet (PRESIDENT) |
| Authorized Official Contact | 3034437226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Front Range Preventive Imaging 2880 Folsom St Suite 100 Boulder CO 80304-3769 Ph: (303) 443-7226 | Front Range Preventive Imaging 2880 Folsom St Suite 100 Boulder CO 80304-3769 Ph: (303) 443-7226 |
| NPI Number | 1104911361 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 0840282422 |
|---|---|
| Medicare Enrollment ID | O20040401001681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104911361 | NPI | - | NPPES |
| 04021960 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amy O Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033108642 PECOS PAC ID: 4688640154 Enrollment ID: I20040907000448 |
| Provider Name | William L Blanchet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659466837 PECOS PAC ID: 7911999594 Enrollment ID: I20070308000130 |
| Provider Name | Jennifer Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710006382 PECOS PAC ID: 9638270499 Enrollment ID: I20070723000808 |
| Provider Name | Kylie Andrea Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447776737 PECOS PAC ID: 2769746510 Enrollment ID: I20180503001249 |
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