Provider Demographics
NPI:1932857976
Name:VAIL SUMMIT ORTHOPAEDICS
Entity Type:Organization
Organization Name:VAIL SUMMIT ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-241-0202
Mailing Address - Street 1:2472 PATTERSON RD UNIT 8
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1100
Mailing Address - Country:US
Mailing Address - Phone:970-241-0202
Mailing Address - Fax:970-245-0250
Practice Address - Street 1:822 W 4TH ST
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3861
Practice Address - Country:US
Practice Address - Phone:970-668-3633
Practice Address - Fax:970-668-4406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAIL SUMMIT ORTHOPAEDICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty