Organization
IRON HORSE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRI M BAGNALL M.D. (PRESIDENT/PEDIATRICIAN)
(719) 633-3850
Entity
Organization
Contact information
Practice address
402 N TEJON ST, SUITE 200, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
(719) 227-0840
Mailing address
402 N TEJON ST, SUITE 200, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
(719) 227-0840
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01237718
—
CO
05
—
01306075
—
CO
05
—
11820314
—
CO
05
—
25386026
—
CO
05
—
35972068
—
CO
Enumeration date
03/02/2009
Last updated
03/01/2017
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