Provider Demographics
NPI:1497076681
Name:FIRSTDOC PC
Entity Type:Organization
Organization Name:FIRSTDOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-391-4303
Mailing Address - Street 1:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-0479
Mailing Address - Country:US
Mailing Address - Phone:970-391-4303
Mailing Address - Fax:
Practice Address - Street 1:1690 MEADE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1552
Practice Address - Country:US
Practice Address - Phone:970-391-4303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty