Provider Demographics
NPI:1770504979
Name:COMPREHENSIVE GYNECOLOGIC CARE, P.C.
Entity Type:Organization
Organization Name:COMPREHENSIVE GYNECOLOGIC CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-460-7116
Mailing Address - Street 1:6363 W 120TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-0300
Mailing Address - Country:US
Mailing Address - Phone:303-460-7116
Mailing Address - Fax:303-460-8204
Practice Address - Street 1:6363 W 120TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-0300
Practice Address - Country:US
Practice Address - Phone:303-460-7116
Practice Address - Fax:303-460-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28418207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE60767Medicare UPIN
COC803216Medicare ID - Type Unspecified