Organization
PEDIATRIC PARTNERS OF THE SOUTHWEST P.C.
Active
Organization
PEDIATRIC PARTNERS OF THE SOUTHWEST P.C.
Active
Parent organization
PEDIATRIC PARTNERS OF THE SOUTHWEST P.C.
Other names
Pediatric Partners of the Southwest P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC PARTNERS OF THE SOUTHWEST P.C.
Authorized official
ALEXANDER SCHACKEL (PRACTICE ADMINISTRATOR)
(970) 375-0100
Entity
Organization
Contact information
Practice address
658 S EAST ST STE 301, BAYFIELD, CO 81122-5020
(970) 375-0100
Mailing address
810 E 3RD ST UNIT 301, DURANGO, CO 81301-5760
(970) 375-0100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
948843159
—
CO
Enumeration date
01/21/2022
Last updated
01/21/2022
Update your record
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