Provider Demographics
NPI:1720049026
Name:INTERNAL MEDICINE SOUTHWEST
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SOUTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-933-8240
Mailing Address - Street 1:6169 S BALSAM WAY
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3062
Mailing Address - Country:US
Mailing Address - Phone:303-933-8240
Mailing Address - Fax:303-933-8205
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:SUITE 190
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3062
Practice Address - Country:US
Practice Address - Phone:303-933-8240
Practice Address - Fax:303-933-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCC8138OtherRAILROAD MEDICARE
CO04018529Medicaid
CO04018529Medicaid