Organization
SALIDA GENERAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFAN IVERSON DO (GENERAL SURGEON)
(719) 286-3170
Entity
Organization
Contact information
Practice address
1101 PINON DR, PONCHA SPRINGS, CO 81242-5084
(719) 286-3170
Mailing address
PO BOX 1295, PONCHA SPRINGS, CO 81242-1003
(719) 286-3170
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/02/2025
Last updated
12/12/2025
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