Basic Information
Provider Information
NPI: 1205304201
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY PHYSICIANS INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CU MEDICINE ORTHOPEDICS - HIGHLANDS RANCH SPECIALTY CARE CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 110429
Address2:  
City: AURORA
State: CO
PostalCode: 800420429
CountryCode: US
TelephoneNumber: 3034937000
FaxNumber:  
Practice Location
Address1: 1500 PARK CENTRAL DR STE 401
Address2:  
City: HIGHLANDS RANCH
State: CO
PostalCode: 801296935
CountryCode: US
TelephoneNumber: 7205164090
FaxNumber: 7205164086
Other Information
ProviderEnumerationDate: 11/07/2018
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALBERTSON
AuthorizedOfficialFirstName: GAIL
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: VP/LOO
AuthorizedOfficialTelephone: 3034937120
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
207X00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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