Provider Demographics
NPI:1164852190
Name:ROCKY MOUNTAIN PAIN SPECIALISTS
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN PAIN SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AUTH. OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-805-7246
Mailing Address - Street 1:16830 NORTHGATE DRIVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5778
Mailing Address - Country:US
Mailing Address - Phone:303-805-7246
Mailing Address - Fax:303-840-7159
Practice Address - Street 1:16830 NORTHGATE DR
Practice Address - Street 2:STE 130
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5778
Practice Address - Country:US
Practice Address - Phone:303-805-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty