Healthcare Provider Details

I. General information

NPI: 1033303797
Provider Name (Legal Business Name): NORTHERN COLORADO HAND & WRIST CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E HARMONY RD UNIT 260
FORT COLLINS CO
80528-3402
US

IV. Provider business mailing address

1175 58TH AVE STE 202
GREELEY CO
80634-4807
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-2827
  • Fax: 970-221-2854
Mailing address:
  • Phone: 970-495-0300
  • Fax: 970-224-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number01038212A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number46063
License Number StateCO

VIII. Authorized Official

Name: JOHN H MAHON
Title or Position: PRESIDENT
Credential: MD
Phone: 970-221-2827