Provider Demographics
NPI:1013990043
Name:ROCKY MOUNTAIN RADIOLOGISTS PC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN RADIOLOGISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUYON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-753-1191
Mailing Address - Street 1:1873 S BELLAIRE ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4358
Mailing Address - Country:US
Mailing Address - Phone:303-753-1191
Mailing Address - Fax:303-753-6636
Practice Address - Street 1:8300 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6005
Practice Address - Country:US
Practice Address - Phone:303-425-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04400081Medicaid