Healthcare Provider Details

I. General information

NPI: 1639220221
Provider Name (Legal Business Name): ROCKY MOUNTAIN CARDIOVASCULAR SURGEONS, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 SO POTOMAC STREET SUITE 211
AURORA CO
80012-4502
US

IV. Provider business mailing address

1455 SO POTOMAC STREET SUITE 211
AURORA CO
80012-4502
US

V. Phone/Fax

Practice location:
  • Phone: 303-695-1313
  • Fax: 303-695-5121
Mailing address:
  • Phone: 303-695-1313
  • Fax: 303-695-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number21817
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number21817
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number21817
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number21817
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number21817
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number21817
License Number StateCO

VIII. Authorized Official

Name: MRS. MARCIA SUE VOSS
Title or Position: OFFICE/BUSINESS MGR
Credential:
Phone: 303-695-1313