Provider Demographics
NPI:1568232296
Name:THREE PEAKS FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:THREE PEAKS FAMILY MEDICINE, LLC
Other - Org Name:THREE PEAKS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:KOLFENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:303-909-9654
Mailing Address - Street 1:98 WADSWORTH BLVD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1552
Mailing Address - Country:US
Mailing Address - Phone:720-603-4615
Mailing Address - Fax:720-609-2791
Practice Address - Street 1:98 WADSWORTH BLVD UNIT 120
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1552
Practice Address - Country:US
Practice Address - Phone:303-909-9654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty