# BOULDERCENTRE FOR ORTHOPEDICS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336197631
- **Authorized official:** INGRID ANDERSON (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (303) 607-6363

## Contact information

- **Practice address:** 4740 PEARL PKWY, SUITE 200, BOULDER, CO 80301-3078
- **Practice address phone:** (303) 449-2730
- **Practice address fax:** (303) 449-5821
- **Mailing address:** 4740 PEARL PKWY STE 200, BOULDER, CO 80301-3080
- **Mailing address phone:** (303) 449-2730
- **Mailing address fax:** (303) 449-5821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 02/26/2026