Provider Demographics
NPI:1003256777
Name:COLORADO PHYSICIAN PARTNERS, PLLC
Entity Type:Organization
Organization Name:COLORADO PHYSICIAN PARTNERS, PLLC
Other - Org Name:COLORADO PHYSICIAN PARTNERS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMUNDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-237-2779
Mailing Address - Street 1:205 S GARRISON ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2843
Mailing Address - Country:US
Mailing Address - Phone:720-728-5170
Mailing Address - Fax:720-866-9967
Practice Address - Street 1:205 S GARRISON ST STE A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2843
Practice Address - Country:US
Practice Address - Phone:720-728-5170
Practice Address - Fax:720-866-9967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty