Healthcare Provider Details

I. General information

NPI: 1437800877
Provider Name (Legal Business Name): ORTHOPEDIC CENTERS OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 RESEARCH PKWY STE 105
COLORADO SPRINGS CO
80920-1093
US

IV. Provider business mailing address

8101 E LOWRY BLVD STE 120
DENVER CO
80230-7195
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-1700
  • Fax: 303-301-1759
Mailing address:
  • Phone: 720-865-6072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN DAVIS
Title or Position: VP OF BUSINESS
Credential:
Phone: 303-815-4182