Provider Demographics
NPI:1356825848
Name:MOUNTAIN VIEW SURGICAL ASSOCIATES-SUMMIT, PC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW SURGICAL ASSOCIATES-SUMMIT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-805-1855
Mailing Address - Street 1:9399 CROWN CREST BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8508
Mailing Address - Country:US
Mailing Address - Phone:303-805-1855
Mailing Address - Fax:
Practice Address - Street 1:360 PEAK ONE DR # 390
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5948
Practice Address - Country:US
Practice Address - Phone:303-805-1855
Practice Address - Fax:303-805-4421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty