Provider Demographics
NPI:1013273911
Name:ROCKY MOUNTAIN NEUROSURGERY PC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN NEUROSURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:720-484-6908
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:9695 S YOSEMITE ST
Practice Address - Street 2:SUITE 377
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:720-484-6908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN NEUROSURGERY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-04
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site