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NPI Code Detail

MEDICARE: COLORADO WEST OTOLARYNGOLOGISTS PC

MEDICARE: COLORADO WEST OTOLARYNGOLOGISTS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant
22086S0122XPlastic and Reconstructive Surgery Physician
3208200000XPlastic Surgery Physician
4231H00000XAudiologist
5363LF0000XFamily Nurse Practitioner
6207Y00000XOtolaryngology Physician
7363A00000XPhysician Assistant
8207ND0101XMOHS-Micrographic Surgery Physician
9207YX0905XOtolaryngology/Facial Plastic Surgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306831250
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLORADO WEST OTOLARYNGOLOGISTS PC
Provider Business Mailing Address
First Line : 2515 FORESIGHT CIR UNIT 200
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-1156
Country : US
Telephone Number : 970-245-2400
Fax Number : 970-242-9092
Provider Business Practice Location Address
First Line : 2515 FORESIGHT CIR UNIT 200
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-1156
Country : US
Telephone Number : 970-245-2400
Fax Number : 970-242-9092
Authorized Official
Title or Position : CREDENTIALING
Name : SANDY VALENTINE
Credential :
Telephone Number : 970-245-2400
Provider Enumeration Date : 09/16/2005
Last Update Date : 10/01/2025

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Directions to “COLORADO WEST OTOLARYNGOLOGISTS PC ” Practice Location

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