# FRONT RANGE GERIATRIC MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194261362
- **Authorized official:** CLAUDIA M DORE (BILLING MANAGER)
- **Authorized official phone:** (303) 660-6561

## Contact information

- **Practice address:** 802 W DRAKE RD, SUITE 101, FORT COLLINS, CO 80526-5558
- **Practice address phone:** (970) 482-0198
- **Mailing address:** 802 W DRAKE RD, SUITE 101, FORT COLLINS, CO 80526-5558
- **Mailing address phone:** (970) 482-0198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/12/2017
- **Last updated:** 01/14/2022