Healthcare Provider Details

I. General information

NPI: 1508940925
Provider Name (Legal Business Name): HIGH COUNTRY ORTHOPAEDICS & SPORTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 STAFFORD LN
DELTA CO
81416-2273
US

IV. Provider business mailing address

PO BOX 1129
DELTA CO
81416-1129
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-4399
  • Fax: 970-874-7558
Mailing address:
  • Phone: 970-874-2470
  • Fax: 970-874-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number33382
License Number StateCO

VIII. Authorized Official

Name: DOUGLAS B HUENE
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 970-874-4399