Healthcare Provider Details

I. General information

NPI: 1508413071
Provider Name (Legal Business Name): SURGONE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 375
DENVER CO
80220-3987
US

IV. Provider business mailing address

8490 E CRESCENT PKWY STE 380
GREENWOOD VILLAGE CO
80111-2815
US

V. Phone/Fax

Practice location:
  • Phone: 303-296-1370
  • Fax: 303-296-5085
Mailing address:
  • Phone: 303-957-1310
  • Fax: 303-761-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELBY UHERNIK
Title or Position: CEO
Credential:
Phone: 303-957-1310