Organization
DEBORAH GREEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY SALAS MD PC (OWNER)
(303) 857-6111
Entity
Organization
Contact information
Practice address
315 PARK AVE, FORT LUPTON, CO 80621-1929
(303) 857-6111
(303) 857-2459
Mailing address
315 PARK AVE, FORT LUPTON, CO 80621-1929
(303) 857-6111
(303) 857-2459
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
241330
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010022980
RR PTAN
CO
05
—
01241330
—
CO
Enumeration date
12/18/2007
Last updated
08/30/2013
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