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Organization
THE PATHOLOGY GROUP PC
Active
Organization
THE PATHOLOGY GROUP PC
Active
Other names
The Pathology Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN M HAVLIK MD (PRESIDENT)
(970) 256-6266
Entity
Organization
Contact information
Practice address
2351 G ROAD, COMMUNITY HOSPITAL, GRAND JUNCTION, CO 81505
(970) 549-4140
(432) 223-2147
Mailing address
PO BOX 4235, GRAND JUNCTION, CO 81502
(970) 256-6463
(970) 549-4140
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04023412
—
CO
01
—
CI3527
RAILROAD MEDICARE
—
Enumeration date
11/03/2005
Last updated
01/21/2020
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