Individual
CHARLES KING BIBBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 CREST DR, CIMARRON, CO 81220-9503
(970) 314-1303
(970) 314-1303
Mailing address
180 CREST DR, CIMARRON, CO 81220-9503
(970) 314-1303
(970) 314-1303
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35924
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145072001
—
AR
01
—
35924
MEDICAL LICENSE #
CO
05
—
65673336
—
CO
01
—
PO1223844
RAILROAD MCARE
AR
Enumeration date
05/05/2006
Last updated
11/15/2013
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