Provider Demographics
NPI:1306271630
Name:FACIAL ASSOCIATES OF COLORADO FOR EMERGENCY SERVICES, PLLC
Entity type:Organization
Organization Name:FACIAL ASSOCIATES OF COLORADO FOR EMERGENCY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-329-0040
Mailing Address - Street 1:2770 N UNION BLVD
Mailing Address - Street 2:100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1120
Mailing Address - Country:US
Mailing Address - Phone:719-329-0040
Mailing Address - Fax:719-329-0080
Practice Address - Street 1:2770 N UNION BLVD
Practice Address - Street 2:100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1120
Practice Address - Country:US
Practice Address - Phone:719-329-0040
Practice Address - Fax:719-329-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty