Organization
MOFFAT FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY KIPE M.D. (PARTNER)
(970) 824-3252
Entity
Organization
Contact information
Practice address
600 RUSSELL ST, CRAIG, CO 81625-2018
(970) 824-3252
(970) 824-8025
Mailing address
600 RUSSELL ST, CRAIG, CO 81625-2018
(970) 824-3252
(970) 824-8025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04624045
—
CO
01
—
CS7054
ANTHEM
CO
Enumeration date
01/09/2007
Last updated
05/01/2015
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