Ford, Jack
Ford, Jack is an sole proprietor health care provider with primary practice located at 3505 Austin Bluffs Pkwy Ste 306 , Colorado Springs CO 80918-5755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Ford, Jack can be contacted via phone (719) 475-1810.Contact Information
Primary practice address
3505 Austin Bluffs Pkwy Ste 306
Colorado Springs CO 80918-5755
Phone: (719) 475-1810
Fax: (719) 475-1812
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | DR0016135 | Colorado |
Profile Details
NPI number | 1558363234 |
---|---|
LBN Legal business name | Ford, Jack |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 12th, 2005 |
Last updated | Feb 17th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1558363234 | NPPES |
Colorado | MEDICAID | 01161355 |
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