Healthcare Provider Details

I. General information

NPI: 1215981634
Provider Name (Legal Business Name): ROCKY MOUNTAIN PRIMARY CARE , PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 W 92ND AVE
WESTMINSTER CO
80021-4567
US

IV. Provider business mailing address

7625 W 92ND AVE
WESTMINSTER CO
80021-4567
US

V. Phone/Fax

Practice location:
  • Phone: 303-252-7790
  • Fax: 303-650-2287
Mailing address:
  • Phone: 303-252-7790
  • Fax: 303-650-2287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN CAMPBELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 256-282-9568