Organization
DOCTORS SURGERY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN WYCHE BICKEL M.D. (CEO)
(719) 545-6013
Entity
Organization
Contact information
Practice address
4100 JERRY MURPHY RD, PUEBLO, CO 81001-1076
(719) 545-6013
(719) 545-2054
Mailing address
4100 JERRY MURPHY RD, PUEBLO, CO 81001-1076
(719) 545-6013
(719) 545-2054
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
137
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00389
BLU CROSS BLUE SHIELD
CO
05
—
04510384
—
CO
01
—
490003790
RAIL ROAD MEDICARE
CO
Enumeration date
06/20/2005
Last updated
09/17/2013
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