Healthcare Provider Details

I. General information

NPI: 1801994157
Provider Name (Legal Business Name): CENTERS FOR GASTROENTEROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 S TIMBERLINE RD
FORT COLLINS CO
80525-3624
US

IV. Provider business mailing address

3702 S TIMBERLINE RD
FORT COLLINS CO
80525-3624
US

V. Phone/Fax

Practice location:
  • Phone: 970-207-9773
  • Fax: 970-207-1893
Mailing address:
  • Phone: 970-207-9773
  • Fax: 970-207-1893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: BILLIE BEDDOE
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 970-212-0879