Samuel Blake Ecker (NPI# 1033555230, PAC ID# 6305112509) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1033555230 |
| PAC ID by PECOS | 6305112509 |
| Professional Enrollment ID | I20190129002988 |
| Full Name | Samuel Blake Ecker |
| Organization Legal Name | ADVANCED DERMATOLOGY OF COLORADO PC |
| Address |
1006 Centre Ave Fort Collins CO 80526-1849 |
| Phone Number | 9704843050 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 8325337330 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060010 | POUDRE VALLEY HOSPITAL |
| 060119 | MEDICAL CENTER OF THE ROCKIES |
| Address | Phone | Organization |
|---|---|---|
| 1006 Centre Ave, Fort Collins, CO 80526-1849 | 9704843050 | ADVANCED DERMATOLOGY OF COLORADO PC |
| 2500 Rocky Mountain Ave, Suite 350, Loveland, CO 80538-9004 | 9704843050 | ADVANCED DERMATOLOGY OF COLORADO PC |
| Organization Legal Name | ADVANCED DERMATOLOGY OF COLORADO PC |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Narina Grove | Pathology | Advanced Dermatology of Colorado PC | 1100 Poudre River Dr, Unit A, Fort Collins, CO 80524-3557 |
| Tyler O Vukmer | Dermatology | Advanced Dermatology of Colorado PC | 2970 Quebec St, Suite 200, Denver, CO 80207-2931 |
| Matthew S Laffer | Dermatology | Advanced Dermatology of Colorado PC | 1551 Milky Way, Thornton, CO 80260-4713 |
| Kelly E Pavelich | Physician Assistant | Advanced Dermatology of Colorado PC | 9101 Harlan St, Unit 155, Westminster, CO 80031-2925 |
| Robert Henry Packer | Dermatology | Advanced Dermatology of Colorado PC | 3455 W Lutheran Pkwy, 110 Advanced Dermatology, Wheat Ridge, CO 80033-6041 |
| Robert Chase Wright | Dermatology | Advanced Dermatology of Colorado PC | 8550 W 38th Ave, Suite 108, Wheat Ridge, CO 80033-4341 |
| Anne Lise A Hultsch | Dermatology | Advanced Dermatology of Colorado PC | 3726 S Timberline Rd, Suite 101, Fort Collins, CO 80525-4332 |
| Stephen P Castle | Dermatology | Advanced Dermatology of Colorado PC | 7251 W 20th St, Unit E, Greeley, CO 80634-4626 |
| Peggy B Liao | Dermatology | Advanced Dermatology of Colorado PC | 2200 E 18th Ave, Denver, CO 80206-1205 |
| James R Devito | Dermatology | Advanced Dermatology of Colorado PC | 9570 S Kingston Ct, Suite 100, Englewood, CO 80112-6004 |
| Street Address |
1006 CENTRE AVE |
| City | FORT COLLINS |
| State | CO |
| Zip | 80526-1849 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anne Marie Wallace | General Surgery | Advanced Dermatology of Colorado PC | 1006 Centre Ave, Fort Collins, CO 80526-1849 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samuel Tyson Fischer | Physical Therapy | 2100 W Drake Rd, Suite 3, Fort Collins, CO 80526-1400 | |
| Joan Rawlings Welsh | Psychologist, Clinical | 1856 Michael Ln, Suite 1, Fort Collins, CO 80526-1698 | |
| Mark Camden Loury | Otolaryngology | Advanced Otolaryngology, P.C. | 2001 S Shields St Bldg, E101, Fort Collins, CO 80526-1827 |
| Mark Rotman | Family Medicine | Associates In Family Medicine P C | 2001 S Shields Bldg, Suite 1, Fort Collins, CO 80526-1827 |
| Samantha Lindsay | Physical Therapy | Berkana Rehabilitation Pllc | 2001 S Shields St, Bldg A, Fort Collins, CO 80526-1827 |
| Matthew David Giordanelli | Physical Therapy | Berkana Rehabilitation Pllc | 2001 S Shields St, Bldg A, Fort Collins, CO 80526-1827 |
| Kelvin Daves Witt | Chiropractic | 2001 S Shields St, Building H Suite 101, Fort Collins, CO 80526-1827 | |
| Reed M Soukup | Physician Assistant | Advanced Otolaryngology, P.C. | 2001 S Shields St Bldg, E101, Fort Collins, CO 80526-1827 |
| Nancy Quick | Physical Therapy | Berkana Rehabilitation Pllc | 2001 S Shields St, Bldg A, Fort Collins, CO 80526-1827 |
| Gloria N Phillips | Qualified Audiologist | Advanced Otolaryngology, P.C. | 2001 S Shields St Bldg, E101, Fort Collins, CO 80526-1827 |
| Find all physicians in zip 80526 | |||
| City | FORT COLLINS |
| Zip Code | 80526 |
| Specialty | DERMATOLOGY |
| City + Specialty | FORT COLLINS + DERMATOLOGY |
Please comment or provide details below to improve the information on Samuel Blake Ecker.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.