Basic Information
Provider Information
NPI: 1871007880
EntityType: 2
ReplacementNPI:  
OrganizationName: SOUTHWEST ENDOSCOPY PARTNERS LLC
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Mailing Information
Address1: 401 COMMERCE ST STE 600
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372192518
CountryCode: US
TelephoneNumber: 6153456900
FaxNumber:  
Practice Location
Address1: 2 BURNETT CT STE 200
Address2:  
City: DURANGO
State: CO
PostalCode: 813013647
CountryCode: US
TelephoneNumber: 9702599369
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/29/2017
LastUpdateDate: 11/29/2017
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AuthorizedOfficialLastName: POLLEY
AuthorizedOfficialFirstName: WHIT
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AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 6153456900
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QA1903X  Y Ambulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical

No ID Information.


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