Provider Demographics
NPI:1578745527
Name:NORTHERN COLORADO PROFESSIONAL PHYSICIANS, PC
Entity Type:Organization
Organization Name:NORTHERN COLORADO PROFESSIONAL PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-870-9131
Mailing Address - Street 1:940 CENTRAL PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8816
Mailing Address - Country:US
Mailing Address - Phone:970-870-9131
Mailing Address - Fax:970-870-9240
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8816
Practice Address - Country:US
Practice Address - Phone:970-870-9131
Practice Address - Fax:970-870-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-02
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41642207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO811360Medicare PIN