# FRASER PROFESSIONAL MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Flying Horse Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194313346
- **Authorized official:** DR. AARON SOOTS FRASER D.O.L (MEDICAL DIRECTOR)
- **Authorized official phone:** (719) 633-5255

## Contact information

- **Practice address:** 77 3RD ST, MONUMENT, CO 80132-8179
- **Practice address phone:** (719) 633-5255
- **Practice address fax:** (719) 488-6753
- **Mailing address:** 77 3RD ST, MONUMENT, CO 80132-8179
- **Mailing address phone:** (719) 633-5255
- **Mailing address fax:** (719) 488-6753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 01/04/2021
- **Last updated:** 02/05/2024