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Organization
ALLIANCE FAMILY PRACTICE
Active
Organization
ALLIANCE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK PHILP CARROLL II M.D. (MEDICAL DIRECTOR)
(719) 282-6337
Entity
Organization
Contact information
Practice address
9320 GRAND CORDERA PKWY, SUITE 100, COLORADO SPRINGS, CO 80924-7003
(719) 282-6337
(719) 282-0532
Mailing address
9320 GRAND CORDERA PKWY, SUITE 100, COLORADO SPRINGS, CO 80924-7003
(719) 282-6337
(719) 282-0532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
NULL
207RI0011X
Interventional Cardiology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/11/2007
Last updated
01/15/2014
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