Provider Demographics
NPI:1568616951
Name:NORTH VISTA MEDICAL PARTNERS LLC
Entity Type:Organization
Organization Name:NORTH VISTA MEDICAL PARTNERS LLC
Other - Org Name:NORTH VISTA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:R
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-501-2600
Mailing Address - Street 1:4943 STATE HWY 52
Mailing Address - Street 2:STE. 240
Mailing Address - City:DACONO
Mailing Address - State:CO
Mailing Address - Zip Code:80514
Mailing Address - Country:US
Mailing Address - Phone:303-501-2600
Mailing Address - Fax:877-764-4622
Practice Address - Street 1:4943 STATE HIGHWAY 52 STE 240
Practice Address - Street 2:
Practice Address - City:DACONO
Practice Address - State:CO
Practice Address - Zip Code:80514-9107
Practice Address - Country:US
Practice Address - Phone:303-501-2600
Practice Address - Fax:877-764-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care