Individual
DR. DEBRA J MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
729 E SPAULDING AVE, PUEBLO WEST, CO 81007-3512
(719) 547-9119
(719) 547-7555
Mailing address
729 E SPAULDING AVE, PUEBLO WEST, CO 81007-3512
(719) 547-9119
(719) 547-7555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27445
AL
207Q00000X
Family Medicine Physician
Primary
DR.0051488
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38673533
—
CO
01
—
51535235
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
05
—
9939616
—
AL
01
—
P00344585
RAILROAD MEDICARE
AL
01
—
P01100409
RAILROAD MEDICARE
CO
Enumeration date
12/20/2005
Last updated
08/15/2016
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