Healthcare Provider Details

I. General information

NPI: 1831799576
Provider Name (Legal Business Name): HEART OF THE ROCKIES RADIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 EDWARDS AVE
WESTCLIFFE CO
81252-8835
US

IV. Provider business mailing address

PO BOX 7704
LOVELAND CO
80537-0704
US

V. Phone/Fax

Practice location:
  • Phone: 719-545-1607
  • Fax: 970-342-2093
Mailing address:
  • Phone: 970-663-2742
  • Fax: 970-342-2093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL ALEXANDER WARDROP
Title or Position: OWNER/AUTHORIZED REP
Credential: MD
Phone: 970-663-2742