Healthcare Provider Details

I. General information

NPI: 1699086710
Provider Name (Legal Business Name): ROCKY MOUNTAIN NEUROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 S QUEBEC ST STE 150
CENTENNIAL CO
80111-4554
US

IV. Provider business mailing address

5975 S QUEBEC ST STE 150
CENTENNIAL CO
80111-4554
US

V. Phone/Fax

Practice location:
  • Phone: 303-790-8899
  • Fax: 303-790-2810
Mailing address:
  • Phone: 303-790-8899
  • Fax: 303-790-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number37976
License Number StateCO

VIII. Authorized Official

Name: DR. AMELIA SCOTT BARRETT
Title or Position: PRESIDENT
Credential: MD
Phone: 303-790-8899