Provider Demographics
NPI:1962851600
Name:ROCKY MOUNTAIN BRAIN & SPINE EMERGENCY SERVICES LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN BRAIN & SPINE EMERGENCY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-471-4690
Mailing Address - Street 1:206 W COUNTY LINE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2318
Mailing Address - Country:US
Mailing Address - Phone:303-471-4690
Mailing Address - Fax:303-471-4697
Practice Address - Street 1:206 W COUNTY LINE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2318
Practice Address - Country:US
Practice Address - Phone:303-471-4690
Practice Address - Fax:303-471-4697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0049595207PE0004X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty