# HERITAGE FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Senior Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669535118
- **Authorized official:** SCOTT TALBOT (OPERATIONS MANAGER)
- **Authorized official phone:** (970) 224-1596

## Contact information

- **Practice address:** 1006 ROBERTSON ST, FORT COLLINS, CO 80524
- **Practice address phone:** (970) 224-1596
- **Practice address fax:** (970) 530-1919
- **Mailing address:** 1006 ROBERTSON ST, FORT COLLINS, CO 80524
- **Mailing address phone:** (970) 224-1596
- **Mailing address fax:** (970) 530-1919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 36358 | CO | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 01/07/2014