Healthcare Provider Details

I. General information

NPI: 1043162027
Provider Name (Legal Business Name): SKI TOWN IV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 E HOPKINS AVE STE D
ASPEN CO
81611-2937
US

IV. Provider business mailing address

PO BOX 15088
PHOENIX AZ
85060-5088
US

V. Phone/Fax

Practice location:
  • Phone: 970-742-7889
  • Fax: 970-742-7890
Mailing address:
  • Phone: 970-742-7889
  • Fax: 970-742-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AJAY BHATNAGAR
Title or Position: OWNER AND PHYSICIAN
Credential: MD
Phone: 970-742-7889