Organization
WOODLAND PARK FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW C YOUNG M.D. (PARTNER PHYSICIAN)
(719) 686-2801
Entity
Organization
Contact information
Practice address
16222 W US HIGHWAY 24, STE 200, WOODLAND PARK, CO 80863-8762
(719) 686-2801
(719) 686-2809
Mailing address
16222 W US HIGHWAY 24, SUITE 200, WOODLAND PARK, CO 80863-8762
(719) 686-2801
(719) 686-2809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41134711
—
CO
01
—
810093
MEDICARE
CO
Enumeration date
06/01/2007
Last updated
08/06/2008
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