Provider Demographics
NPI:1336808492
Name:NEW WEST PHYSICIANS INC
Entity Type:Organization
Organization Name:NEW WEST PHYSICIANS INC
Other - Org Name:TABLE MOUNTAIN FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HECKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-763-4900
Mailing Address - Street 1:1707 COLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3219
Mailing Address - Country:US
Mailing Address - Phone:303-763-4900
Mailing Address - Fax:
Practice Address - Street 1:110 N RUBEY DR UNIT 200
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-3201
Practice Address - Country:US
Practice Address - Phone:303-376-0975
Practice Address - Fax:303-731-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty