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Organization

STONEY MESA FAMILY PRACTICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE PURVIS MD (PHYSICIAN/OWNER)
(970) 874-5061
Entity
Organization

Contact information

Practice address
1722 HILLCREST DR, DELTA, CO 81416-2810
(970) 874-5061
(970) 874-5074
Mailing address
PO BOX 1129, DELTA, CO 81416-1129
(970) 874-2470
(970) 874-2475

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39111
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83777865
CO
01
ST802592
BCBS
CO
Enumeration date
11/19/2007
Last updated
11/07/2008
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