| Kelby F. Bethards MD Prof. LLC | |
|
1017 Robertson St Fort Collins CO 80524-3926 | |
| (970) 472-5000 | |
| (970) 490-6161 |
| Full Name | Kelby F. Bethards MD Prof. LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1017 Robertson St, Fort Collins, Colorado |
| Authorized Official Name and Position | Kelby F. Bethards (OWNER) |
| Authorized Official Contact | 9704725000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelby F. Bethards MD Prof. LLC 1017 Robertson St Fort Collins CO 80524-3926 Ph: (970) 472-5000 | Kelby F. Bethards MD Prof. LLC 1017 Robertson St Fort Collins CO 80524-3926 Ph: (970) 472-5000 |
| NPI Number | 1720067036 |
|---|---|
| Provider Enumeration Date | 01/13/2006 |
| Last Update Date | 03/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720067036 | NPI | - | NPPES |
| 47802871 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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