Organization
SOUTHWEST EMERGENCY PHYSICIANS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GRAHAM MD (PRESIDENT)
(970) 247-4311
Entity
Organization
Contact information
Practice address
1010 THREE SPRINGS BLVD, EMERGENCY DEPARTMENT, DURANGO, CO 81301-8296
(970) 764-2100
Mailing address
PO BOX 17752, DENVER, CO 80217-0752
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46454314
—
CO
05
—
50178598
—
NM
01
—
S0674431
BCBS
—
Enumeration date
07/09/2006
Last updated
12/21/2015
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