Provider Demographics
NPI:1518980630
Name:WESTERN SLOPE ORTHOPAEDICS
Entity Type:Organization
Organization Name:WESTERN SLOPE ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODING/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-249-6641
Mailing Address - Street 1:910 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4226
Mailing Address - Country:US
Mailing Address - Phone:970-249-6641
Mailing Address - Fax:970-249-5148
Practice Address - Street 1:910 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4226
Practice Address - Country:US
Practice Address - Phone:970-249-6641
Practice Address - Fax:970-249-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81401A001OtherTRICARE
COWEK9008OtherBCBS
CO4008447OtherMEDICAID
COCI5594OtherRAILROAD MEDICARE
COCK9008Medicare PIN
CO4008447OtherMEDICAID