Provider Demographics
NPI:1467671933
Name:COLORADO PLASTIC SURGERY, P.C.
Entity Type:Organization
Organization Name:COLORADO PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:SLENKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-783-1000
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2736
Mailing Address - Country:US
Mailing Address - Phone:303-783-1000
Mailing Address - Fax:303-783-1001
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-783-1000
Practice Address - Fax:303-783-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H96070Medicare UPIN