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General NPI Number Information
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NPI Number | 1568087682
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN PEDIATRIC UROLOGY, PC
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 575 RIVERGATE UNIT 109
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City | DURANGO
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State | CO
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Zip | 81301-7488
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Country | US
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Telephone | 303-839-7200
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Fax | 303-839-7229
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Provider Business Mailing Address
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Address Line | 1601 E 19TH AVE STE 6400
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City | DENVER
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State | CO
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Zip | 80218-1294
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Country | US
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Telephone | 303-839-7200
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Fax | 303-839-7229
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. PETER FURNESS
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Credential | MD
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Telephone | 303-839-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number |
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License Number State |
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