Provider Demographics
NPI:1245759752
Name:MINIMALLY INVASIVE PROCEDURE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE PROCEDURE SPECIALISTS PLLC
Other - Org Name:MIPS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-805-7477
Mailing Address - Street 1:8671 S QUEBEC ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5861
Mailing Address - Country:US
Mailing Address - Phone:303-805-7477
Mailing Address - Fax:303-805-7478
Practice Address - Street 1:8671 S QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130
Practice Address - Country:US
Practice Address - Phone:303-805-7477
Practice Address - Fax:303-805-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO480342085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty