Organization
GARY W. CAGE MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY W CAGE MD (OWNER)
(970) 845-7872
Entity
Organization
Contact information
Practice address
70 BENCHMARK ROAD, SUITE 203, AVON, CO 81620
(970) 845-7872
(970) 845-7869
Mailing address
PO BOX 4450, 70 BENCHMARK ROAD SUITE 203, AVON, CO 81620-4450
(970) 845-7872
(970) 845-7869
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34904
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C15351
MEDICARE PTAN
CO
01
—
COB5082
PTAN GROUP
CO
Enumeration date
04/04/2007
Last updated
06/23/2010
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