Provider Demographics
NPI:1922043645
Name:MAPLETON HILL ORTHOPAEDICS PC
Entity Type:Organization
Organization Name:MAPLETON HILL ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-440-7941
Mailing Address - Street 1:PO BOX 7208
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-0208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:975 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3356
Practice Address - Country:US
Practice Address - Phone:970-663-2742
Practice Address - Fax:970-667-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCB3989OtherRAILROAD MEDICARE
CO04007126Medicaid
CO04007126Medicaid