Provider Demographics
NPI:1346269438
Name:PEDIATRIX MEDICAL GROUP OF COLORADO
Entity Type:Organization
Organization Name:PEDIATRIX MEDICAL GROUP OF COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-860-9933
Mailing Address - Street 1:10103 RIDGEGATE PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5520
Mailing Address - Country:US
Mailing Address - Phone:303-860-9933
Mailing Address - Fax:303-839-5844
Practice Address - Street 1:10103 RIDGEGATE PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5520
Practice Address - Country:US
Practice Address - Phone:303-860-9933
Practice Address - Fax:303-839-5844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty