Individual
PHILLIP M. FALENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
4110 BRIARGATE PKWY, SUITE 300, COLORADO SPRINGS, CO 80920-7835
(719) 632-7669
(719) 632-0088
Mailing address
4110 BRIARGATE PKWY, SUITE 300, COLORADO SPRINGS, CO 80920-7835
(719) 632-7669
(719) 632-0088
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
CO1643
CO
363AM0700X
Medical Physician Assistant
CO1643
CO
363AS0400X
Surgical Physician Assistant
CO1643
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14536820
—
CO
01
—
970029212
RR MEDICARE
CO
Enumeration date
05/31/2006
Last updated
05/15/2014
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