Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1043217607
Practice Locations (4)
ST MARYS PHYSICIAN SERVICES LLC
105 SKYLINE DR
RUSSELLVILLE, AR 728013363
4799682345
POUDRE VALLEY MEDICAL GROUP LLC
4404 BARRANCA LN, UNIT 101
CASTLE ROCK, CO 801047419
7207335260
POUDRE VALLEY MEDICAL GROUP LLC
400 W 16TH ST
PUEBLO, CO 810032745
7195844921
POUDRE VALLEY MEDICAL GROUP LLC
4010 JERRY MURPHY RD
PUEBLO, CO 810011045
7195622021
Source: CMS National Downloadable File, September 2026.