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Organization
ORTHOPAEDIC & SPINE CENTER OF THE ROCKIES PC
Active
Organization
ORTHOPAEDIC & SPINE CENTER OF THE ROCKIES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BERGERSON (CHIEF EXECUTIVE OFFICER)
(970) 419-7005
Entity
Organization
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04640082
—
CO
05
—
107463601
—
WY
01
—
CS8670
RR MEDICARE
CO
Enumeration date
09/20/2005
Last updated
12/30/2019
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