Healthcare Provider Details

I. General information

NPI: 1669111498
Provider Name (Legal Business Name): ORTHOPAEDICS OF STEAMBOAT SPRINGS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17230 JACKSON CREEK PKWY STE 260
MONUMENT CO
80132-7305
US

IV. Provider business mailing address

705 MARKETPLACE PLZ STE 200
STEAMBOAT SPRINGS CO
80487-1841
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-3010
  • Fax: 970-871-1234
Mailing address:
  • Phone: 970-879-6663
  • Fax: 970-871-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA HOGUE
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 970-879-6663