Healthcare Provider Details

I. General information

NPI: 1326643636
Provider Name (Legal Business Name): STEAMBOAT MEDICAL PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W JACKSON ST.
HAYDEN CO
81639
US

IV. Provider business mailing address

1475 PINE GROVE RD., STE. 102
STEAMBOAT SPRINGS CO
80487
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-0203
  • Fax: 970-879-1389
Mailing address:
  • Phone: 970-879-0203
  • Fax: 970-879-1389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA A SMITH
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 970-879-0203