# PHC-FORT MORGAN INC

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

## Provider details

- **NPI number:** 1770537490
- **Authorized official:** MR. WILLIAM M. GRACEY (COO)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 1000 LINCOLN ST, FORT MORGAN, CO 80701-3210
- **Practice address phone:** (970) 867-3391
- **Practice address fax:** (970) 542-3306
- **Mailing address:** 1000 LINCOLN ST, CS4200, FORT MORGAN, CO 80701-3210
- **Mailing address phone:** (970) 867-3391
- **Mailing address fax:** (970) 542-3306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207UN0901X | Nuclear Cardiology Physician | — | NULL | — |
| 207UN0901X | Nuclear Cardiology Physician | — | — | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 09/09/2008