Organization
PIKES PEAK INTERNAL MEDICINE ASSOCIATES, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE LAURANCE MD (OWNER)
(719) 535-8900
Entity
Organization
Contact information
Practice address
1465 KELLY JOHNSON BLVD, SUITE 310, COLORADO SPRINGS, CO 80920-3955
(719) 535-8900
Mailing address
1465 KELLY JOHNSON BLVD, SUITE 310, COLORADO SPRINGS, CO 80920-3955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29883
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
541858
MEDICARE GROUP LEGACY
CO
Enumeration date
10/15/2007
Last updated
10/15/2007
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