Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Prairie Medical Clinic PLLC

Organization Family Medicine Physician · NPI 1891914693

Prairie Medical Clinic PLLC provides Family Medicine Physician services 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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