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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