Provider Demographics
NPI:1700498797
Name:COLORADO SPORTS MEDICINE AND ORTHOPAEDICS
Entity Type:Organization
Organization Name:COLORADO SPORTS MEDICINE AND ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-275-6924
Mailing Address - Street 1:4071 S DAHLIA ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILLS VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80113-5145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 E 9TH AVE STE 420
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3931
Practice Address - Country:US
Practice Address - Phone:720-726-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty