1245239268 NPI number — MUSCULOSKELETAL SURGERY CENTER OF COLORADO

Table of content: (NPI 1245239268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245239268 NPI number — MUSCULOSKELETAL SURGERY CENTER OF COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUSCULOSKELETAL SURGERY CENTER OF COLORADO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245239268
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 1063
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80256-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-288-4694
Provider Business Mailing Address Fax Number:
303-288-4697

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9005 GRANT ST
Provider Second Line Business Practice Location Address:
SUITE #300
Provider Business Practice Location Address City Name:
THORNTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80229-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-288-4694
Provider Business Practice Location Address Fax Number:
303-288-4697
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MCPHERSON
Authorized Official First Name:
HUGH
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
303-287-2800

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  0572 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 654031 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: P00126001 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 00212806101 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 7483316 . This is a "AETNA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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