Basic Information
| Provider Information | |||||||||
| NPI: | 1861947657 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN FAMILY MEDICINE, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1107 S LEMAY AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805243960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704841757 | ||||||||
| FaxNumber: | 9704849924 | ||||||||
| Practice Location | |||||||||
| Address1: | 1107 S LEMAY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805243959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704841757 | ||||||||
| FaxNumber: | 9704849924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2016 | ||||||||
| LastUpdateDate: | 08/31/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOSNESS | ||||||||
| AuthorizedOfficialFirstName: | HELEN | ||||||||
| AuthorizedOfficialMiddleName: | JEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING/PHYSICIAN SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 9704956291 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ASSOCIATES IN FAMILY MEDICINE, P.C. | ||||||||
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| NPICertificationDate: | 08/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.