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General NPI Number Information
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NPI Number | 1104018878
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Entity Type | Organization
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Legal Business Name | MONTROSE EARS, NOSE AND THROAT CENTER, L.L.C.
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 231 S NEVADA AVE STE A
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City | MONTROSE
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State | CO
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Zip | 81401-4233
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Country | US
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Telephone | 970-249-3800
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Fax | 970-249-3838
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Provider Business Mailing Address
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Address Line | 231 S NEVADA AVE STE A
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City | MONTROSE
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State | CO
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Zip | 81401-4233
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Country | US
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Telephone | 970-249-3800
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Fax | 970-249-3838
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES EDWARD HARPER
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Credential | M.D.
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Telephone | 970-249-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | PENDING
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License Number State | CO
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