Provider Demographics
NPI:1295008472
Name:EPIX ANESTHESIA OF COLORADO SPRINGS, LLC
Entity Type:Organization
Organization Name:EPIX ANESTHESIA OF COLORADO SPRINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPELAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-635-7321
Mailing Address - Street 1:PO BOX 731855
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1855
Mailing Address - Country:US
Mailing Address - Phone:844-793-1380
Mailing Address - Fax:770-559-1231
Practice Address - Street 1:2940 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1160
Practice Address - Country:US
Practice Address - Phone:719-635-7321
Practice Address - Fax:719-635-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty