Healthcare Provider Details

I. General information

NPI: 1497776553
Provider Name (Legal Business Name): ALPINE SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W SPENCER AVE STE B
GUNNISON CO
81230-2546
US

IV. Provider business mailing address

711 N TAYLOR ST
GUNNISON CO
81230-2208
US

V. Phone/Fax

Practice location:
  • Phone: 970-641-4522
  • Fax: 970-641-0282
Mailing address:
  • Phone: 970-641-0282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATHAN BLAD
Title or Position: CFO
Credential:
Phone: 970-642-4760