Organization
SOUTH PARK MEDICAL GROUP,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FITTING MD (PRESIDENT/OWNER)
(719) 836-1900
Entity
Organization
Contact information
Practice address
824 CASTELLO STREET, FAIRPLAY, CO 80440
(719) 836-1900
Mailing address
PO BOX 760, FAIRPLAY, CO 80440-0760
(719) 836-1900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28085
CO
Other
Enumeration date
08/14/2007
Last updated
02/20/2008
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