Basic Information
Provider Information
NPI: 1689226250
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: 1000 CHOPPER CIR
Address2:  
City: DENVER
State: CO
PostalCode: 802045805
CountryCode: US
TelephoneNumber: 3034937000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2019
LastUpdateDate: 12/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALBERTSON
AuthorizedOfficialFirstName: GAIL
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: VP/COO
AuthorizedOfficialTelephone: 7208489500
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XX0005X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


Home