Healthcare Provider Details

I. General information

NPI: 1922401975
Provider Name (Legal Business Name): COLORADO OB/GYN PARTNERS 2, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9195 GRANT ST SUITE 410
THORNTON CO
80229-4385
US

IV. Provider business mailing address

5909 PEACHTREE DUNWOODY RD SUITE 900
ATLANTA GA
30328-8102
US

V. Phone/Fax

Practice location:
  • Phone: 303-280-2229
  • Fax: 303-280-0765
Mailing address:
  • Phone: 404-943-0205
  • Fax: 404-943-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LATOYSHA DANGLER
Title or Position: MANAGER
Credential:
Phone: 404-214-4286