Provider Demographics
NPI:1689695694
Name:OPENSIDED MRI OF DENVER, LLC
Entity Type:Organization
Organization Name:OPENSIDED MRI OF DENVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PLATUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-363-1007
Mailing Address - Street 1:5250 LEETSDALE DR
Mailing Address - Street 2:STE 125
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1438
Mailing Address - Country:US
Mailing Address - Phone:303-331-1500
Mailing Address - Fax:303-331-1505
Practice Address - Street 1:5250 LEETSDALE DR
Practice Address - Street 2:STE 125
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-331-1500
Practice Address - Fax:303-331-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7189851Medicaid
CO61043Medicare PIN