Healthcare Provider Details

I. General information

NPI: 1013274281
Provider Name (Legal Business Name): SPORTS AND FAMILY MEDICINE OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6390 GARDENIA ST UNIT 140
ARVADA CO
80004-3536
US

IV. Provider business mailing address

6390 GARDENIA ST UNIT 140
ARVADA CO
80004-3536
US

V. Phone/Fax

Practice location:
  • Phone: 720-898-1110
  • Fax: 720-898-1113
Mailing address:
  • Phone: 720-898-1110
  • Fax: 720-898-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TOD SWEENEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 720-898-1110