# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** SCL Health Medical Group - Lafayette Womens Health (MFM, OBYN, Urogyn), Intermountain Health Lafayette Women's Clinic -Maternal Fetal Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962184077
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP OF FINANCE)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 300 EXEMPLA CIR STE 470, LAFAYETTE, CO 80026-3396
- **Practice address phone:** (303) 673-1440
- **Practice address fax:** (303) 673-1360
- **Mailing address:** 500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
- **Mailing address phone:** (303) 272-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | Yes |
| 2088F0040X | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | — | NULL | — |
| 2088F0040X | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | — | — | — |

## Other

- **Enumeration date:** 08/07/2023
- **Last updated:** 06/28/2024