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Organization

PAGOSA SPRINGS FAMILY MEDICINE CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES C PRUITT M.D. (OWNER)
(970) 731-4131
Entity
Organization

Contact information

Practice address
75 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8330
(970) 731-4131
(970) 731-9384
Mailing address
PO BOX 7638, LOVELAND, CO 80537-0638

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06D0518606
NM BCBS
NM
05
74603051
CO
01
PAP07008
BCBS
CO
Enumeration date
03/20/2007
Last updated
05/15/2009
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