Provider Demographics
NPI:1063853356
Name:COLORADO ORTHOPEDIC CONSULTANTS PC
Entity Type:Organization
Organization Name:COLORADO ORTHOPEDIC CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-695-6060
Mailing Address - Street 1:1411 S POTOMAC ST STE 400
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4540
Mailing Address - Country:US
Mailing Address - Phone:303-695-6060
Mailing Address - Fax:
Practice Address - Street 1:401 W HAMPDEN PL STE 220
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2471
Practice Address - Country:US
Practice Address - Phone:303-695-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00043887207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04004404Medicaid
COCL8208OtherMEDICARE