1891438065 NPI number — VAIL-SUMMIT ORTHOPAEDICS PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891438065 NPI number — VAIL-SUMMIT ORTHOPAEDICS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VAIL-SUMMIT ORTHOPAEDICS PC
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:
VAIL SUMMIT ORTHOPAEDICS AND NEUROSURGERY
Provider Other Organization Name Type Code:
3
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:
1891438065
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2472 PATTERSON RD UNIT 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81505-1100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-241-0202
Provider Business Mailing Address Fax Number:
970-245-0250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 CROSSMAN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUENA VISTA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81211-9649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-668-3633
Provider Business Practice Location Address Fax Number:
970-668-4406
Provider Enumeration Date:
04/15/2022

Additional Information

Authorized Official

Authorized Official Last Name:
KINLUND
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
970-477-4456

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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