Organization
DELTA FAMILY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE R MIXTER M.D. (PRESIDENT)
(970) 874-5777
Entity
Organization
Contact information
Practice address
555 MEEKER ST, DELTA, CO 81416-1920
(970) 874-5777
(970) 874-1631
Mailing address
555 MEEKER ST, DELTA, CO 81416-1920
(970) 874-5777
(970) 874-1631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207Q0000X
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04009379
—
CO
01
—
CI8541
RR MC GRP ID
CO
Enumeration date
08/11/2006
Last updated
10/05/2007
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