Provider Demographics
NPI:1689952947
Name:CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES COLORADO
Other - Org Name:SYNERGY ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.M.O.
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-804-8119
Mailing Address - Street 1:P.O. BOX 911057
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1057
Mailing Address - Country:US
Mailing Address - Phone:303-486-5401
Mailing Address - Fax:303-486-5502
Practice Address - Street 1:8510 BRYANT ST.
Practice Address - Street 2:SUITE 320
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:303-430-6410
Practice Address - Fax:303-430-6420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC483178Medicare PIN