Provider Demographics
NPI:1134222334
Name:STEAMBOAT MEDICAL PARTNERS PC
Entity type:Organization
Organization Name:STEAMBOAT MEDICAL PARTNERS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-879-0203
Mailing Address - Street 1:1475 PINE GROVE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8851
Mailing Address - Country:US
Mailing Address - Phone:970-879-0203
Mailing Address - Fax:970-879-1389
Practice Address - Street 1:1475 PINE GROVE RD
Practice Address - Street 2:SUITE #102
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8803
Practice Address - Country:US
Practice Address - Phone:970-879-0203
Practice Address - Fax:970-879-1389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31220347Medicaid
COCG0823OtherRAILROAD MEDICARE
CO0390360001Medicare NSC
COCG0823OtherRAILROAD MEDICARE