| South Park Medical Group,pc | |
|
824 Castello Street Fairplay CO 80440 | |
| (719) 836-1900 | |
| Not Available |
| Full Name | South Park Medical Group,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 824 Castello Street, Fairplay, Colorado |
| Authorized Official Name and Position | Katherine Fitting (PRESIDENT/OWNER) |
| Authorized Official Contact | 7198361900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Park Medical Group,pc Po Box 760 Fairplay CO 80440-0760 Ph: (719) 836-1900 | South Park Medical Group,pc 824 Castello Street Fairplay CO 80440 Ph: (719) 836-1900 |
| NPI Number | 1245422245 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 02/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245422245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 28085 (Colorado) | Primary |
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