Provider Demographics
NPI:1750092201
Name:PANORAMA ORTHOPEDICS & SPINE CENTER, PC
Entity type:Organization
Organization Name:PANORAMA ORTHOPEDICS & SPINE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-587-3061
Mailing Address - Street 1:660 GOLDEN RIDGE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9541
Mailing Address - Country:US
Mailing Address - Phone:303-233-1223
Mailing Address - Fax:
Practice Address - Street 1:7987 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2715
Practice Address - Country:US
Practice Address - Phone:720-845-6880
Practice Address - Fax:720-845-6884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy