Basic Information
Provider Information
NPI: 1508598145
EntityType: 2
ReplacementNPI:  
OrganizationName: ORTHOPEDIC CENTERS OF COLORADO, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8101 E LOWRY BLVD STE 120
Address2:  
City: DENVER
State: CO
PostalCode: 802307195
CountryCode: US
TelephoneNumber: 7208656072
FaxNumber: 7208656072
Practice Location
Address1: 14100 E ARAPAHOE RD STE 210
Address2:  
City: CENTENNIAL
State: CO
PostalCode: 801124028
CountryCode: US
TelephoneNumber: 3033449090
FaxNumber: 3033441922
Other Information
ProviderEnumerationDate: 06/30/2022
LastUpdateDate: 06/30/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DAVIS
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP OF BUISNESS
AuthorizedOfficialTelephone: 3038154182
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ORTHOPEDIC CENTERS OF COLORADO, LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home