Provider Demographics
NPI:1841644598
Name:LONE TREE EMERGENCY & TRAUMA SURGERY SPECIALISTS
Entity type:Organization
Organization Name:LONE TREE EMERGENCY & TRAUMA SURGERY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHOEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-841-2660
Mailing Address - Street 1:10103 RIDGEGATE PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5520
Mailing Address - Country:US
Mailing Address - Phone:303-841-2660
Mailing Address - Fax:303-841-2966
Practice Address - Street 1:10103 RIDGEGATE PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5520
Practice Address - Country:US
Practice Address - Phone:303-841-2660
Practice Address - Fax:303-841-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR52894208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1669673414Medicare PIN