Basic Information
| Provider Information | |||||||||
| NPI: | 1487074795 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAMILY PHYSICIANS AT HIGHLANDS RANCH | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 7960 S UNIVERSITY BLVD STE 101 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801223167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037910301 | ||||||||
| FaxNumber: | 3037918511 | ||||||||
| Practice Location | |||||||||
| Address1: | 7960 S UNIVERSITY BLVD STE 101 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801223167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037910301 | ||||||||
| FaxNumber: | 3037918511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2014 | ||||||||
| LastUpdateDate: | 04/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | MCLEAN | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 3037910301 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | 36684 | CO | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.