Organization
FAMILY MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
C DAVID NEECE D.O. (OWNER/PROVIDER)
(719) 738-1164
Entity
Organization
Contact information
Practice address
100 W 4TH ST, WALSENBURG, CO 81089-1910
(719) 738-1164
(719) 738-3399
Mailing address
100 W 4TH ST, WALSENBURG, CO 81089-1910
(719) 738-1164
(719) 738-3399
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
27053
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C444298
MEDICARE GROUP NUMBER
CO
Enumeration date
08/23/2007
Last updated
09/20/2016
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