Provider Demographics
NPI:1659477198
Name:FAMILY PRAC INPATIEN INC PC
Entity Type:Organization
Organization Name:FAMILY PRAC INPATIEN INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-321-9700
Mailing Address - Street 1:3531 S LOGAN
Mailing Address - Street 2:D347
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3700
Mailing Address - Country:US
Mailing Address - Phone:303-321-9700
Mailing Address - Fax:303-953-9211
Practice Address - Street 1:3531 S LOGAN ST
Practice Address - Street 2:D347
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3700
Practice Address - Country:US
Practice Address - Phone:303-321-9700
Practice Address - Fax:303-953-9211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32509375Medicaid
COC443018Medicare PIN