Provider Demographics
NPI:1275120347
Name:SKIN CANCER AND DERMATOLOGY CENTER OF COLORADO SPRINGS, P.C.
Entity Type:Organization
Organization Name:SKIN CANCER AND DERMATOLOGY CENTER OF COLORADO SPRINGS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:SARTORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-574-0310
Mailing Address - Street 1:1975 RESEARCH PKWY STE 165
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1026
Mailing Address - Country:US
Mailing Address - Phone:719-574-0310
Mailing Address - Fax:719-574-6574
Practice Address - Street 1:328 S BONAVENTURE AVE STE 2
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-2086
Practice Address - Country:US
Practice Address - Phone:719-574-0518
Practice Address - Fax:719-574-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty