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Organization

SALIDA FAMILY MEDICINE

Active
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Organization

SALIDA FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRUDY L FOGG (PRACTICE ADMINISTATOR)
(719) 539-3583
Entity
Organization

Contact information

Practice address
320 E 1ST ST, SALIDA, CO 81201
(719) 539-3612
(719) 539-3028
Mailing address
320 E 1ST ST, SALIDA, CO 81201-2802
(719) 539-3612
(719) 539-3028

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
NULL
173000000X
Legal Medicine
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
07/09/2006
Last updated
06/14/2018
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