Individual
DR. BENTLEY COLE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 CARSON AVE, LA JUNTA, CO 81050-2751
(303) 770-4491
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32381
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1323815
—
CO
Enumeration date
05/08/2006
Last updated
07/16/2013
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