Organization
MOUNTAIN STATES PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS WILLIAM FRANQUEMONT MD (PRESIDENT)
(719) 776-5816
Entity
Organization
Contact information
Practice address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907
(719) 776-5000
Mailing address
PO BOX 744127, DALLAS, TX 75374
(719) 776-5816
(719) 776-2108
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04020889
—
CO
05
—
04978722
—
CO
05
—
119630800
—
WY
05
—
12174823
—
CO
05
—
25157329
—
CO
05
—
66282829
—
CO
05
—
806943700
—
ID
05
—
806943702
—
ID
05
—
806943703
—
ID
05
—
806943704
—
ID
05
—
806943705
—
ID
Enumeration date
04/13/2006
Last updated
12/17/2007
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