Organization
TRINIDAD MEDICAL ASSOCIATES , LLC
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CARLISLE M.D. (OWNER)
(719) 845-0627
Entity
Organization
Contact information
Practice address
400 BENEDICTA AVE, SUITE E, TRINIDAD, CO 81082-2089
(719) 845-0627
(719) 845-0663
Mailing address
400 BENEDICTA AVE, SUITE E, TRINIDAD, CO 81082-2089
(719) 845-0627
(719) 845-0663
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638937
—
CO
Enumeration date
05/17/2006
Last updated
08/22/2020
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