Healthcare Provider Details

I. General information

NPI: 1710069091
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 E. HALE PKWY SUITE 550
DENVER CO
80220-4045
US

IV. Provider business mailing address

4700 E. HALE PKWY SUITE 550
DENVER CO
80220-4045
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-6600
  • Fax: 303-321-8814
Mailing address:
  • Phone: 303-321-6600
  • Fax: 303-321-8814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DEB L ROTH
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 303-321-6600