Basic Information
Provider Information
NPI: 1619241965
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY PHYSICIANS, INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UNIVERSITY OF COLORADO MEDICINE
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: 3034937202
Practice Location
Address1: 12605 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208481980
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/05/2012
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALBERTSON
AuthorizedOfficialFirstName: GAIL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: COO
AuthorizedOfficialTelephone: 3034937000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 
261QP3300X  Y Ambulatory Health Care FacilitiesClinic/CenterPain

No ID Information.


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