Provider Demographics
NPI:1467183129
Name:CONIFER MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:CONIFER MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-647-5280
Mailing Address - Street 1:26659 PLEASANT PARK RD
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7768
Mailing Address - Country:US
Mailing Address - Phone:303-647-5280
Mailing Address - Fax:877-892-7288
Practice Address - Street 1:30940 STAGECOACH BLVD STE E270
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7782
Practice Address - Country:US
Practice Address - Phone:303-647-5300
Practice Address - Fax:877-892-7288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVERGREEN FAMILY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty