Healthcare Provider Details
I. General information
NPI: 1144110552
Provider Name (Legal Business Name): SURGONE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 EXEMPLA CIR STE 230
LAFAYETTE CO
80026-2906
US
IV. Provider business mailing address
8490 E CRESCENT PKWY STE 380
GREENWOOD VILLAGE CO
80111-2815
US
V. Phone/Fax
- Phone: 303-325-8703
- Fax: 303-325-8704
- Phone: 303-957-1310
- Fax: 303-761-4252
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
SHELBY
UHERNIK
Title or Position: CEO
Credential: MBA
Phone: 303-957-1310