Provider Demographics
NPI:1043987050
Name:AHEAD COLORADO MEDICAL PC
Entity Type:Organization
Organization Name:AHEAD COLORADO MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-306-7786
Mailing Address - Street 1:2000 S COLORADO BLVD
Mailing Address - Street 2:TOWER ONE STE 2000-1001
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7900
Mailing Address - Country:US
Mailing Address - Phone:855-306-7786
Mailing Address - Fax:415-367-3629
Practice Address - Street 1:2000 S COLORADO BLVD
Practice Address - Street 2:TOWER ONE STE 2000-1001
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7900
Practice Address - Country:US
Practice Address - Phone:855-306-7786
Practice Address - Fax:415-367-3629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty