# POUDRE VALLEY MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Other names:** UCHealth Gastroenterology Clinic - Fort Collins, UCHealth Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063042687
- **Legal business name:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Authorized official:** JANA CONROY (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (970) 495-7420

## Contact information

- **Practice address:** 1025 GARFIELD ST STE B, FORT COLLINS, CO 80524-3930
- **Practice address phone:** (970) 495-7420
- **Practice address fax:** (970) 495-7609
- **Mailing address:** 2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
- **Mailing address phone:** (970) 495-7420
- **Mailing address fax:** (970) 495-7609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 05/03/2024