Basic Information
Provider Information
NPI: 1275045049
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY PHYSICIANS, INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CU SPORTS MEDICINE COLORADO 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: 2000 S COLORADO BLVD STE 4500
Address2:  
City: DENVER
State: CO
PostalCode: 802227900
CountryCode: US
TelephoneNumber: 7208488200
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/01/2017
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALBERTSON
AuthorizedOfficialFirstName: GAIL
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: VP/COO
AuthorizedOfficialTelephone: 7208489500
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  N193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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