Healthcare Provider Details
I. General information
NPI: 1104116896
Provider Name (Legal Business Name): OBHG COLORADO, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2011
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4050 BRIARGATE PKWY
COLORADO SPRINGS CO
80920-7815
US
IV. Provider business mailing address
777 LOWNDES HILL RD BLDG 1
GREENVILLE SC
29607-2101
US
V. Phone/Fax
- Phone: 800-967-2289
- Fax: 864-627-9920
- Phone: 800-967-2289
- Fax: 864-627-9920
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENISE
BURNS
Title or Position: DIRECTOR
Credential:
Phone: 864-908-3604