Provider Demographics
NPI:1982746517
Name:FRONT RANGE PAIN SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:FRONT RANGE PAIN SPECIALISTS, P.C.
Other - Org Name:DR. STEPHEN M. FORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ANESTHESIOLOGIST PAIN MANAGEMENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-579-9131
Mailing Address - Street 1:PO BOX 26627
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80936-6627
Mailing Address - Country:US
Mailing Address - Phone:719-579-9131
Mailing Address - Fax:719-268-1766
Practice Address - Street 1:1615 MEDICAL CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5788
Practice Address - Country:US
Practice Address - Phone:719-579-9131
Practice Address - Fax:719-268-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34354174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80918A002OtherTRIWEST WPS GROUP NBR
CODB8061OtherRR MEDICARE GROUP
CO01343540Medicaid
COP00129307OtherRR MEDICARE ID
COFOF39070OtherBLUE CROSS BLUE SHIELD ID
CO71138731Medicaid
CODB8061OtherRR MEDICARE GROUP
COP00129307OtherRR MEDICARE ID
COFOF39070OtherBLUE CROSS BLUE SHIELD ID
CO01343540Medicaid