Provider Demographics
NPI:1558959551
Name:CORNERSTONE PEDIATRICS ASSOCIATES
Entity Type:Organization
Organization Name:CORNERSTONE PEDIATRICS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CARLIN
Authorized Official - Last Name:BUCKNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-673-9030
Mailing Address - Street 1:14184 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8859
Mailing Address - Country:US
Mailing Address - Phone:512-470-5423
Mailing Address - Fax:
Practice Address - Street 1:469 STATE HIGHWAY 7 STE 400
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-8965
Practice Address - Country:US
Practice Address - Phone:303-673-9030
Practice Address - Fax:303-604-1095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty