Provider Demographics
NPI:1659553675
Name:GEORGE V ROSSIE
Entity Type:Organization
Organization Name:GEORGE V ROSSIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRETZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-893-9300
Mailing Address - Street 1:4200 W CONEJOS PL STE 111
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1309
Mailing Address - Country:US
Mailing Address - Phone:303-893-9300
Mailing Address - Fax:303-893-4384
Practice Address - Street 1:4200 W CONEJOS PL STE 111
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1309
Practice Address - Country:US
Practice Address - Phone:303-893-9300
Practice Address - Fax:303-893-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO799174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COR21231Medicare UPIN
CO434908Medicare PIN