Basic Information
Provider Information
NPI: 1730347113
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY PHYSICIANS INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BARBARA DAVIS CENTER FOR CHILDHOOD DIABETES
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: 1775 AURORA CT
Address2:  
City: AURORA
State: CO
PostalCode: 80045
CountryCode: US
TelephoneNumber: 3037242323
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/02/2008
LastUpdateDate: 12/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALBERTSON
AuthorizedOfficialFirstName: GAIL
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: COO/VP
AuthorizedOfficialTelephone: 3034937000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate: 12/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0205X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
261QM1300X  N Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty
207RE0101X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


Home