Healthcare Provider Details
I. General information
NPI: 1265325542
Provider Name (Legal Business Name): STEADMAN CLINIC PROFESSIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
235 N 7TH ST
GRAND JUNCTION CO
81501-3401
US
IV. Provider business mailing address
181 W MEADOW DR STE 400
VAIL CO
81657-5058
US
V. Phone/Fax
- Phone: 970-476-1100
- Fax:
- Phone: 970-476-1100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0004X |
| Taxonomy | Orthopaedic Foot and Ankle Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TALENA
COX
WILLIAMS
Title or Position: COO
Credential:
Phone: 970-479-5792