Provider Demographics
NPI:1578236360
Name:PANORAMA ORTHOPEDICS AND SPINE CENTER PC
Entity Type:Organization
Organization Name:PANORAMA ORTHOPEDICS AND SPINE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-274-7321
Mailing Address - Street 1:660 GOLDEN RIDGE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9541
Mailing Address - Country:US
Mailing Address - Phone:303-233-1223
Mailing Address - Fax:
Practice Address - Street 1:4700 EAST HALE PKWY STE 330
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4045
Practice Address - Country:US
Practice Address - Phone:720-441-4021
Practice Address - Fax:720-360-1195
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PANORAMA ORTHOPEDICS AND SPINE CENTER PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-27
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center