Provider Demographics
NPI:1417560574
Name:SCL HEALTH MEDICAL GROUP - DENVER, LLC
Entity Type:Organization
Organization Name:SCL HEALTH MEDICAL GROUP - DENVER, LLC
Other - Org Name:LAFAYETTE CLINIC - GENERAL SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-272-0231
Mailing Address - Street 1:500 ELDORADO BLVD STE 6300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3422
Mailing Address - Country:US
Mailing Address - Phone:303-272-0566
Mailing Address - Fax:
Practice Address - Street 1:300 EXEMPLA CIR STE 400
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3396
Practice Address - Country:US
Practice Address - Phone:303-689-6560
Practice Address - Fax:303-689-6550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCL HEALTH FRONT RANGE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty