Healthcare Provider Details

I. General information

NPI: 1902978901
Provider Name (Legal Business Name): ALPINE OBSTETRICS & GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 S 3RD ST
MONTROSE CO
81401-4209
US

IV. Provider business mailing address

715 S 3RD ST
MONTROSE CO
81401-4209
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-6780
  • Fax: 970-252-0112
Mailing address:
  • Phone: 970-249-6780
  • Fax: 970-252-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number33713
License Number StateCO

VIII. Authorized Official

Name: JAMES N. GILHAM
Title or Position: OWNER
Credential: D.O.
Phone: 970-249-6780