Provider Demographics
NPI:1245248723
Name:PERIOPERATIVE PAIN MANAGEMENT IPA
Entity type:Organization
Organization Name:PERIOPERATIVE PAIN MANAGEMENT IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:ABSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-396-6994
Mailing Address - Street 1:PO BOX 17943
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-0943
Mailing Address - Country:US
Mailing Address - Phone:813-287-5718
Mailing Address - Fax:813-287-5728
Practice Address - Street 1:1800 15TH ST
Practice Address - Street 2:STE 200
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4500
Practice Address - Country:US
Practice Address - Phone:970-396-6994
Practice Address - Fax:970-352-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33642208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty