Provider Demographics
NPI:1942698071
Name:FAMILY PHYSICIANS OF GREELEY, LLP
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS OF GREELEY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR AUTHORIZED O
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:JON
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-378-8000
Mailing Address - Street 1:6801 W. 20TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:970-378-8000
Mailing Address - Fax:970-378-8088
Practice Address - Street 1:473 CASTLE PINES AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534
Practice Address - Country:US
Practice Address - Phone:970-587-7881
Practice Address - Fax:970-587-7738
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY PHYSICIANS OF GREELEY LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-23
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty