Organization
INFECTIOUS DISEASE SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN OGDEN (PRACTICE ADMINISTRATOR)
(719) 578-5176
Entity
Organization
Contact information
Practice address
3230 E WOODMEN RD, SUITE 210, COLORADO SPRINGS, CO 80920
(719) 578-5176
(719) 578-5188
Mailing address
3230 E WOODMEN RD, SUITE 210, COLORADO SPRINGS, CO 80920
(719) 578-5176
(719) 578-5188
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04016804
—
CO
01
—
2432037
AETNA
CO
01
—
607027
BLUE CROSS
CO
01
—
CG7556
RAIL ROAD MEDICARE
CO
Enumeration date
07/28/2005
Last updated
07/21/2022
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