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General NPI Number Information
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NPI Number | 1609876556
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Entity Type | Organization
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Legal Business Name | PEAK ONE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 350 PEAK ONE DRIVE
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-668-1458
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Fax | 970-668-1703
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Provider Business Mailing Address
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Address Line | PO BOX 5541
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City | DENVER
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State | CO
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Zip | 80217-5541
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Country | US
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Telephone | 970-668-1458
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Fax | 970-668-1703
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Authorized Official
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Title or Position | PRESIDENT, BOARD OF MANAGERS
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Name | PETER C JANES
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Credential | MD
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Telephone | 970-668-1458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0173
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License Number State | CO
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