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Organization
PREMIER ORTHOPEDICS
Active
Organization
PREMIER ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L. WALDEN M.D. (PRESIDENT)
(719) 570-7272
Entity
Organization
Contact information
Practice address
3920 N UNION BLVD, STE 330, COLORADO SPRINGS, CO 80907-4916
(719) 570-7272
(719) 570-9030
Mailing address
3920 N UNION BLVD, STE 330, COLORADO SPRINGS, CO 80907-4916
(719) 570-7272
(719) 570-9030
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04009056
—
CO
01
—
PRJ3008
BLUE SHIELD GROUP ID
CO
Enumeration date
05/05/2006
Last updated
04/30/2008
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