Provider Demographics
NPI:1205016698
Name:PIKE'S PEAK ORTHOPEDICS PROF. , LLC
Entity type:Organization
Organization Name:PIKE'S PEAK ORTHOPEDICS PROF. , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MESSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-686-2820
Mailing Address - Street 1:PO BOX 7536
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-0208
Mailing Address - Country:US
Mailing Address - Phone:719-686-2820
Mailing Address - Fax:719-686-2830
Practice Address - Street 1:333 NORTH WEST ST
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-0208
Practice Address - Country:US
Practice Address - Phone:719-686-2820
Practice Address - Fax:719-686-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36776207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67250823Medicaid