Provider Demographics
NPI:1720169956
Name:MOUNTAINTOP FAMILY HEALTH PC
Entity Type:Organization
Organization Name:MOUNTAINTOP FAMILY HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-805-5528
Mailing Address - Street 1:12543 N HIGHWAY 83
Mailing Address - Street 2:STE 228
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8800
Mailing Address - Country:US
Mailing Address - Phone:303-805-5528
Mailing Address - Fax:303-805-5529
Practice Address - Street 1:12543 N HIGHWAY 83
Practice Address - Street 2:STE 228
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-8800
Practice Address - Country:US
Practice Address - Phone:303-805-5528
Practice Address - Fax:303-805-5529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33582548Medicaid
C807675OtherMEDICARE GROUP PTAN
C807675OtherMEDICARE GROUP PTAN