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

Michael Thomas Fackler

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1770943508

Michael Thomas Fackler is a Hospitalist in Pueblo, Colorado. Qualified in 2016, 10 years ago. Practices with Northern Colorado Hospitalists Professional LLC, a 85-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
10
Licensed in
CO
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

400 W 16th St
Pueblo, CO 81003-2745
Phone: (719) 584-4921
Fax: (719) 595-7994
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15855 19 Mile Rd, Clinton Township, MI 48038-3504 — (586) 263-2300

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence DR.0062301 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1770943508
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 7, 2016
Last updated in NPPESJune 19, 2019
Mailing addressPo Box 560825, Denver, CO 80256-0825

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHOSPITALIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Northern Colorado Hospitalists Professional Llc — 85 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Pueblo