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DYNAMIC FAMILY MEDICINE PLLC NPI 1639609894


NPI Information

NPI: 1639609894
Provider Name: DYNAMIC FAMILY MEDICINE PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 06D0891310

Address:
5715 KITTERY DR
COLORADO SPRINGS, CO
ZIP 80911
Phone: (719) 392-3883
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DYNAMIC FAMILY MEDICINE PLLC is a family medicine in Colorado Springs, CO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DYNAMIC FAMILY MEDICINE PLLC NPI is 1639609894. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5715 KITTERY DR
COLORADO SPRINGS, CO
ZIP 80911-551
Phone: (719) 392-3883
Fax: (719) 390-6338

The provider's authorized official is Jeremy Ronald Brown .
The authorized official title is Owner/physician and has the following contact phone number (719) 392-3883.

The CLIA number assigned to this NPI record is 06D0891310 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/19/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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