Provider Demographics
NPI:1255306726
Name:COLORADO IMAGING ASSOCIATES PC
Entity Type:Organization
Organization Name:COLORADO IMAGING ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-416-1360
Mailing Address - Street 1:7375 W 52ND AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3748
Mailing Address - Country:US
Mailing Address - Phone:303-223-4448
Mailing Address - Fax:720-501-5199
Practice Address - Street 1:11600 WEST 2ND PLACE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228
Practice Address - Country:US
Practice Address - Phone:720-321-0000
Practice Address - Fax:720-321-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCC7308OtherRRB
CO04987046Medicaid
COCC7308OtherRAILROAD MEDICARE
COCC7308OtherRRB