Basic Information
| Provider Information | |||||||||
| NPI: | 1083201834 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAREPOINT OUTPATIENT BLUE SKY NEUROLOGY PLLC | ||||||||
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| OtherOrganizationName: | CAREPOINT OUTPATIENT BLUE SKY NEUROLOGY AT BSOP ROSE MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17528 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802170528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037814485 | ||||||||
| FaxNumber: | 7202740064 | ||||||||
| Practice Location | |||||||||
| Address1: | 5351 S ROSLYN ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801112131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037814485 | ||||||||
| FaxNumber: | 7202740064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2020 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP/GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 3034362720 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.