Provider Demographics
NPI:1578724340
Name:ROCKY MOUNTAIN FAMILY MEDICAL, PC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN FAMILY MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-399-2880
Mailing Address - Street 1:70 STAFFORD LN
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-2282
Mailing Address - Country:US
Mailing Address - Phone:970-399-2880
Mailing Address - Fax:970-399-2848
Practice Address - Street 1:70 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2282
Practice Address - Country:US
Practice Address - Phone:970-399-2880
Practice Address - Fax:970-399-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty