Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Prairie Medical Clinic PLLC

Organization Family Medicine Physician · NPI 1891914693

Prairie Medical Clinic PLLC is a Family Medicine Physician in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2007.

Licensed in
CO
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1726 S Prairie Ave
Pueblo, CO 81005-2253
Phone: (719) 561-8660
Fax: (719) 561-8660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (CO)

Record details

NPI number1891914693
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Benjamin Martinez — Physician · (719) 561-1291
NPI enumeratedApril 24, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1726 S Prairie Ave, Pueblo, CO 81005-2253

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