Basic Information
| Provider Information | |||||||||
| NPI: | 1609868116 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LA PLATA FAMILY MEDICINE ASSOC PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 316 SAWYER DR | ||||||||
| Address2: | |||||||||
| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813036560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702593110 | ||||||||
| FaxNumber: | 9702596605 | ||||||||
| Practice Location | |||||||||
| Address1: | 316 SAWYER DR | ||||||||
| Address2: | |||||||||
| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702593110 | ||||||||
| FaxNumber: | 9702596605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | LOWE | ||||||||
| AuthorizedOfficialFirstName: | MERYL | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9703755840 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.