Organization
BLUE CREEK MEDICINE PC
Active
Other names
Blue Creek Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KIT K BREKHUS MD (PRESIDENT)
(303) 674-2273
Entity
Organization
Contact information
Practice address
1520 EVERGREEN PKWY, EVERGREEN, CO 80439-7848
(303) 674-2273
Mailing address
PO BOX 1926, EVERGREEN, CO 80437-1926
(303) 674-2273
(303) 670-2160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45959234
—
CO
01
—
BL661575
BLUE SHIELD
CO
01
—
CK5669
RR MEDICARE
CO
Enumeration date
06/20/2006
Last updated
12/03/2008
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