Basic Information
| Provider Information | |||||||||
| NPI: | 1437800877 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPEDIC CENTERS OF COLORADO, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8101 E LOWRY BLVD STE 120 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802307195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208656072 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2430 RESEARCH PKWY STE 105 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809201093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193011700 | ||||||||
| FaxNumber: | 3033011759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2022 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | DAVIS | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF BUSINESS | ||||||||
| AuthorizedOfficialTelephone: | 3038154182 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ORTHOPEDIC CENTERS OF COLORADO, LLC | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RM1200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Magnetic Resonance Imaging (MRI) | 2085B0100X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085D0003X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging |
No ID Information.