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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
2390 MAIN AVE, DURANGO, CO 81301-4638
(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
02/01/2022
Last updated
02/01/2022
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