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POUDRE VALLEY MEDICAL GROUP LLC NPI 1396350476


NPI Information

NPI: 1396350476
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC
Classification: Urology - 208800000X
Entity Type: Organization
Address:
2315 E HARMONY RD STE 140
FORT COLLINS, CO
ZIP 80528
Phone: (970) 484-6700
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POUDRE VALLEY MEDICAL GROUP, LLC is an urology in Fort Collins, CO. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1396350476. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2315 E HARMONY RD STE 140
FORT COLLINS, CO
ZIP 80528-620
Phone: (970) 484-6700
Fax: (970) 484-5723

The provider's authorized official is Jana Conroy .
The authorized official title is Credentialing Manager and has the following contact phone number (970) 624-4443.

The enumeration date for this NPI number is 9/15/2020 and was last updated on 9/15/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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