Healthcare Provider Details

I. General information

NPI: 1154065043
Provider Name (Legal Business Name): NEW WEST PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 S POTOMAC ST STE 320
AURORA CO
80012-4512
US

IV. Provider business mailing address

1707 COLE BLVD STE 100
GOLDEN CO
80401-3219
US

V. Phone/Fax

Practice location:
  • Phone: 303-750-1920
  • Fax: 303-750-0483
Mailing address:
  • Phone: 303-763-4900
  • Fax: 303-763-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA HECKARD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 303-763-4900