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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558363234 NPPES
Colorado MEDICAID 01161355

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