Organization
COLORADO SPRINGS PULMONARY CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL MARIE PETERSON (PRACTICE ADMINISTRATOR)
(719) 471-7064
Entity
Organization
Contact information
Practice address
2312 N NEVADA AVE STE 305, COLORADO SPRINGS, CO 80907-5318
(719) 471-7064
(719) 776-5459
Mailing address
2312 N NEVADA AVE STE 305, COLORADO SPRINGS, CO 80907-5318
(719) 471-7064
(719) 776-5459
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
39343
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04163044
—
CO
01
—
CU0196
RAILROAD MEDICARE
—
Enumeration date
05/30/2007
Last updated
10/16/2024
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