Healthcare Provider Details

I. General information

NPI: 1063386225
Provider Name (Legal Business Name): COLORADO WEST OTOLARYNGOLOGISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 COTTONWOOD ST
DELTA CO
81416-4400
US

IV. Provider business mailing address

2515 FORESIGHT CIR UNIT 200
GRAND JUNCTION CO
81505-1156
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-2400
  • Fax: 970-242-9092
Mailing address:
  • Phone: 970-245-2400
  • Fax: 970-242-9092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MCKAY J MOLINE
Title or Position: PHYSICIAN
Credential: MD
Phone: 970-245-2400