Healthcare Provider Details

I. General information

NPI: 1396336277
Provider Name (Legal Business Name): CAREPOINT OUTPATIENT BLUE SKY NEUROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 02/02/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 S CLARKSON ST
ENGLEWOOD CO
80113-2811
US

IV. Provider business mailing address

PO BOX 17528
DENVER CO
80217-0528
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-4485
  • Fax:
Mailing address:
  • Phone: 888-987-7975
  • Fax: 405-792-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH SMITH
Title or Position: VP/ GENERAL COUNSEL
Credential:
Phone: 303-436-2720