NPI 1700043692 · live from the CMS NPI Registry
Gwynn Antonson, D.O.
Family Medicine in Pueblo, CO. National Provider Identifier 1700043692, active.
NPI record
| NPI | 1700043692 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 4020 Jerry Murphy Rd, Pueblo, CO 81001 |
| Practice phone | 719-546-3600 |
| Enumerated | May 19, 2008 |
| Last updated | May 16, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 0050578 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.