Provider Demographics
NPI:1457306862
Name:FAMILY MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:FAMILY MEDICINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-487-8817
Mailing Address - Street 1:8853 FOX DR STE 200
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6864
Mailing Address - Country:US
Mailing Address - Phone:303-487-8817
Mailing Address - Fax:303-487-0429
Practice Address - Street 1:1022 DEPOT HILL RD
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1068
Practice Address - Country:US
Practice Address - Phone:303-487-8817
Practice Address - Fax:303-487-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04973087Medicare ID - Type Unspecified
CO97308Medicare ID - Type Unspecified