Provider Demographics
NPI:1902015860
Name:ROBERT P VOGT INC
Entity Type:Organization
Organization Name:ROBERT P VOGT INC
Other - Org Name:THE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-266-5244
Mailing Address - Street 1:6005 DELMONICO DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2264
Mailing Address - Country:US
Mailing Address - Phone:719-266-5244
Mailing Address - Fax:719-266-5245
Practice Address - Street 1:6005 DELMONICO DR
Practice Address - Street 2:SUITE 150
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2264
Practice Address - Country:US
Practice Address - Phone:719-266-5244
Practice Address - Fax:719-266-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39147261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88589846Medicaid
COC541278Medicare PIN
COF21038Medicare UPIN