Healthcare Provider Details

I. General information

NPI: 1720686371
Provider Name (Legal Business Name): BOULDER EMERGENCY PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 ARAPAHOE AVE
BOULDER CO
80303-1131
US

IV. Provider business mailing address

PO BOX 173894
DENVER CO
80217-3894
US

V. Phone/Fax

Practice location:
  • Phone: 303-415-7000
  • Fax: 303-306-7753
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY MEYERS
Title or Position: PRESIDENT
Credential: MD
Phone: 303-709-5622