Provider Demographics
NPI:1447431622
Name:PATRICIA J. RAND, MD, PC
Entity Type:Organization
Organization Name:PATRICIA J. RAND, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-574-0384
Mailing Address - Street 1:3910 S CAREFREE CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-3010
Mailing Address - Country:US
Mailing Address - Phone:719-574-0384
Mailing Address - Fax:719-574-0148
Practice Address - Street 1:3910 S CAREFREE CIR
Practice Address - Street 2:SUITE B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3010
Practice Address - Country:US
Practice Address - Phone:719-574-0384
Practice Address - Fax:719-574-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39625261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13457560Medicaid
CO13457560Medicaid
COC802380Medicare PIN