Healthcare Provider Details
I. General information
NPI: 1285101451
Provider Name (Legal Business Name): ALPINE CENTER FOR DIABETES ENDOCRINOLOGY AND METABOLISM PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2018
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
892 W SOUTH BOULDER RD
LOUISVILLE CO
80027-2453
US
IV. Provider business mailing address
2090 KEOTA LN
SUPERIOR CO
80027-8244
US
V. Phone/Fax
- Phone: 720-352-8977
- Fax:
- Phone: 720-352-8977
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
R
FOX
Title or Position: MEMBER
Credential: MD
Phone: 720-923-7209