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Organization

HERITAGE FAMILY MEDICINE

Active
Other names
Heritage Senior Care
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT TALBOT (OPERATIONS MANAGER)
(970) 224-1596
Entity
Organization

Contact information

Practice address
1006 ROBERTSON ST, FORT COLLINS, CO 80524
(970) 224-1596
(970) 530-1919
Mailing address
1006 ROBERTSON ST, FORT COLLINS, CO 80524
(970) 224-1596
(970) 530-1919

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36358
CO
363LG0600X
Gerontology Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
50773241
CO
Enumeration date
12/18/2006
Last updated
01/07/2014
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