# MOUNTAIN MEDICAL CENTER OF BUENA VISTA, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mountain Medical Center of Buena Vista, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386728640
- **Authorized official:** THOMAS E WHITE M.D. (PRESIDENT)
- **Authorized official phone:** (719) 395-8632

## Contact information

- **Practice address:** 36 OAK STREET, BUENA VISTA, CO 81211
- **Practice address phone:** (719) 395-8632
- **Practice address fax:** (719) 395-4971
- **Mailing address:** PO BOX 3129, BUENA VISTA, CO 81211-3129
- **Mailing address phone:** (719) 395-8632
- **Mailing address fax:** (719) 395-4971

## Taxonomy

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

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 05/14/2013