Organization
PINEY CREEK MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL G RATLIFF DO (PRESIDENT)
(303) 766-1006
Entity
Organization
Contact information
Practice address
16728 E SMOKY HILL RD, AURORA, CO 80015-2400
(303) 766-1006
Mailing address
3464 S WILLOW ST, SUITE 198, DENVER, CO 80231-4531
(303) 755-2900
(303) 755-0404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29331285
—
CO
01
—
CG0427
RAILROAD MEDICARE
CO
01
—
PI41532
BLUE SHIELD
CO
Enumeration date
06/13/2006
Last updated
10/31/2007
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