Provider Demographics
NPI:1013543891
Name:SCL HEALTH MEDICAL GROUP - DENVER, LLC
Entity Type:Organization
Organization Name:SCL HEALTH MEDICAL GROUP - DENVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-272-0231
Mailing Address - Street 1:3455 LUTHERAN PKWY STE 285
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6034
Mailing Address - Country:US
Mailing Address - Phone:303-403-6628
Mailing Address - Fax:303-403-6240
Practice Address - Street 1:3455 LUTHERAN PKWY STE 285
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6034
Practice Address - Country:US
Practice Address - Phone:303-403-6628
Practice Address - Fax:303-403-6240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCL HEALTH FRONT RANGE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty