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Organization
PARKVIEW ANCILLARY SERVICES
Active
Organization
PARKVIEW ANCILLARY SERVICES
Active
Parent organization
PARKVIEW ANCILLARY
Other names
Parkview Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKVIEW ANCILLARY
Authorized official
DARRIN R SMITH (SR. VP/COO)
(719) 584-4290
Entity
Organization
Contact information
Practice address
216 W 13TH ST, PUEBLO, CO 81003-3704
(719) 595-7474
(719) 595-7199
Mailing address
408 N MAIN ST, PUEBLO, CO 81003-3123
(719) 595-7417
(719) 542-0809
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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