| Organization Name: | SURFACE CREEK FAMILY PRACTICE, PC |
| NPI Number: | 1558309005 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERYL A HIEBER (ADMINISTRATOR) |
| Mailing Address: | 255 Sw 8th Ave Cedaredge |
| State: | CO US |
| Postal Code: | 814133902 |
| Phone Number: | 9708563146 |
| Fax Number: | 9708564385 |
| NPI Enumeration Date: | 06/04/2006 |
| NPI Last Update Date: | 09/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |