Provider Demographics
NPI:1740385871
Name:NORTH COLORADO ANESTHESIA ASSOCIATES PC
Entity Type:Organization
Organization Name:NORTH COLORADO ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENYON
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-506-6789
Mailing Address - Street 1:1023 39TH AVE
Mailing Address - Street 2:SUITE L
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2502
Mailing Address - Country:US
Mailing Address - Phone:970-352-7366
Mailing Address - Fax:970-352-7367
Practice Address - Street 1:2000 70TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-8626
Practice Address - Country:US
Practice Address - Phone:970-506-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54034540Medicaid
CO54034540Medicaid