Provider Demographics
NPI:1073979597
Name:ROCKY MOUNTAIN ADVANCED SPINE ACCESS, PC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN ADVANCED SPINE ACCESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHOEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:303-841-2660
Mailing Address - Street 1:PO BOX 632290
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80163
Mailing Address - Country:US
Mailing Address - Phone:303-841-2660
Mailing Address - Fax:303-841-2966
Practice Address - Street 1:10103 RIDGEGATE PARKWAY
Practice Address - Street 2:SUITE 207
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-841-2660
Practice Address - Fax:303-841-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52894208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty