# EVERGREEN MEADOWS FAMILY MEDICAL CENTER

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

## Provider details

- **NPI number:** 1447319314
- **Authorized official:** TAM MASON (OFFICE MANAGER)
- **Authorized official phone:** (303) 674-3117

## Contact information

- **Practice address:** 28000 MEADOW DRIVE, SUITE 206, EVERGREEN, CO 80439
- **Practice address phone:** (303) 674-3117
- **Practice address fax:** (303) 674-5776
- **Mailing address:** 28000 MEADOW DRIVE, SUITE 206, EVERGREEN, CO 80439
- **Mailing address phone:** (303) 674-3117
- **Mailing address fax:** (303) 674-5776

## Taxonomy

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

## Other

- **Enumeration date:** 12/07/2006
- **Last updated:** 08/22/2020