Organization
OAK CREEK FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT RANDY DILLON MD (OWNER PRESIDENT MD)
(719) 276-0725
Entity
Organization
Contact information
Practice address
2400 EDISON ST, BRUSH, CO 80723-1640
(702) 453-3799
(702) 453-5741
Mailing address
2550 PINEHURST DR, EVERGREEN, CO 80439-5906
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35220
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78054222
—
CO
Enumeration date
02/08/2007
Last updated
11/13/2015
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