Prairie Medical Clinic Pllc

NPI #1891914693 in Pueblo, Colorado

Provider Information

NPI Number: 1891914693
Entity Type: Organization
Organization Name: Prairie Medical Clinic Pllc
Primary Specialty: Family Medicine
Enumeration Date: Apr 24, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1726 S PRAIRIE AVE
City: Pueblo
State: Colorado
ZIP Code: 81005-2253
Phone: (719) 561-8660

Authorized Official

Name: BENJAMIN MARTINEZ, MD
Title: PHYSICIAN
Phone: (719) 561-1291

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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