# NORTH FORK MEDICAL CLINIC PC

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

## Provider details

- **NPI number:** 1215050489
- **Authorized official:** TIMOTHY C. MEILNER MD (OWNER, AUTHORIZED OFFICIAL)
- **Authorized official phone:** (970) 527-4103

## Contact information

- **Practice address:** 225 MINNESOTA AVE, PAONIA, CO 81428
- **Practice address phone:** (970) 527-4103
- **Practice address fax:** (970) 527-5171
- **Mailing address:** PO BOX 47, PAONIA, CO 81428-0047
- **Mailing address phone:** (970) 527-4103
- **Mailing address fax:** (970) 527-5171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 03/08/2016