# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ridgeline Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376897041
- **Authorized official:** DAVID L WATSON M.D. (C.M.O)
- **Authorized official phone:** (303) 804-8119

## Contact information

- **Practice address:** 831 S PERRY ST, SUITE 200, CASTLE ROCK, CO 80104-1919
- **Practice address phone:** (303) 649-3120
- **Practice address fax:** (303) 649-3121
- **Mailing address:** PO BOX 911244, DENVER, CO 80291-1244
- **Mailing address phone:** (303) 765-6636
- **Mailing address fax:** (303) 486-5502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/02/2012
- **Last updated:** 11/20/2012