1346546447 NPI number — COMPREHENSIVE FAMILY MEDICAL CENTER P.C.

Table of content: DR. ELIZABETH HUGHES TICHY MD (NPI 1073576583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346546447 NPI number — COMPREHENSIVE FAMILY MEDICAL CENTER P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE FAMILY MEDICAL CENTER P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346546447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8200 E BELLEVIEW AVE STE 300C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-221-5400
Provider Business Mailing Address Fax Number:
303-221-4465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8200 E BELLEVIEW AVE STE 300C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWOOD VILLAGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80111-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-221-5400
Provider Business Practice Location Address Fax Number:
303-221-4465
Provider Enumeration Date:
02/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
LEVENSON
Authorized Official First Name:
IAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-221-5400

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25657 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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