POUDRE VALLEY MEDICAL GROUP LLC NPI 1316569387

NPI Information

NPI: 1316569387
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
4050 BRIARGATE PKWY FL 4
COLORADO SPRINGS, CO
ZIP 80920
Phone: (719) 365-1292
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POUDRE VALLEY MEDICAL GROUP, LLC is a general practice in Colorado Springs, CO. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1316569387. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4050 BRIARGATE PKWY FL 4
COLORADO SPRINGS, CO
ZIP 80920-815
Phone: (719) 365-1292
Fax: (719) 365-5004

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 5/13/2020 and was last updated on 5/13/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes

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: 11/14/2023

NPI Synchronization or Removal

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