Basic Information
| Provider Information | |||||||||
| NPI: | 1942918768 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OB-GYN AFFILIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1745 SHEA CENTER DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801291540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203074456 | ||||||||
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| Practice Location | |||||||||
| Address1: | 217 BROADWAY ST UNIT 4 | ||||||||
| Address2: | |||||||||
| City: | EAGLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816315160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037302229 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2022 | ||||||||
| LastUpdateDate: | 11/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | FOELSKE | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED REPRESENTATIVE | ||||||||
| AuthorizedOfficialTelephone: | 7203755845 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | OB-GYN AFFILIATES | ||||||||
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| NPICertificationDate: | 11/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.