Organization
UNCOMPAHGRE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY WAYNE SULLINGER MD (PRESIDENT)
(970) 252-9165
Entity
Organization
Contact information
Practice address
535 S NEVADA AVE, MONTROSE, CO 81401
(970) 252-9165
(970) 252-8874
Mailing address
535 S NEVADA AVE, MONTROSE, CO 81401
(970) 252-9165
(970) 252-8874
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
39301
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81957823
—
CO
01
—
DG4940
RAILROAD MEDICARE
—
Enumeration date
10/03/2006
Last updated
07/30/2012
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