Healthcare Provider Details

I. General information

NPI: 1528895216
Provider Name (Legal Business Name): ALPINE MEDICAL GROUP COLORADO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7444 W ALASKA DR STE 200
LAKEWOOD CO
80226-3331
US

IV. Provider business mailing address

999 17TH ST STE 500
DENVER CO
80202-2728
US

V. Phone/Fax

Practice location:
  • Phone: 303-936-0022
  • Fax: 303-936-5262
Mailing address:
  • Phone: 720-728-5170
  • Fax: 720-866-9967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KERRY DOYLE
Title or Position: SUPERVISOR OF CREDENTIALING
Credential:
Phone: 720-728-5170