Healthcare Provider Details

I. General information

NPI: 1679896625
Provider Name (Legal Business Name): SOUTHWEST CARDIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERCADO ST SUITE 130
DURANGO CO
81301-7306
US

IV. Provider business mailing address

181 E 56TH AVE SUITE 100
DENVER CO
80216-1766
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-1120
  • Fax:
Mailing address:
  • Phone: 303-298-1802
  • Fax: 303-298-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateCO

VIII. Authorized Official

Name: DR. NELSON ARTHUR PRAGER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 303-750-0822