Healthcare Provider Details

I. General information

NPI: 1447797105
Provider Name (Legal Business Name): SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MINERAL AVE STE 9
LITTLETON CO
80122
US

IV. Provider business mailing address

14201 DALLAS PKWY
DALLAS TX
75254-2916
US

V. Phone/Fax

Practice location:
  • Phone: 720-360-3400
  • Fax: 720-360-3410
Mailing address:
  • Phone: 972-763-3859
  • Fax: 972-920-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HARTSHORN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 314-800-2017