Provider Demographics
NPI:1891468302
Name:SCL HEALTH MEDICAL GROUP DENVER LLC
Entity Type:Organization
Organization Name:SCL HEALTH MEDICAL GROUP DENVER LLC
Other - Org Name:INTERMOUNTAIN HEALTH LUTHERAN SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-272-0231
Mailing Address - Street 1:500 ELDORADO BLVD STE 6300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3422
Mailing Address - Country:US
Mailing Address - Phone:303-272-0566
Mailing Address - Fax:303-403-6245
Practice Address - Street 1:1687 COLE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3318
Practice Address - Country:US
Practice Address - Phone:303-403-6688
Practice Address - Fax:303-403-6245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCL HEALTH FRONT RANGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-29
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty