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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(719) 365-5134
Entity
Organization

Contact information

Practice address
525 BOB PETERS GRV STE 302, COLORADO SPRINGS, CO 80909-4533
(719) 365-5134
(719) 365-8060
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(719) 365-5134
(719) 365-8060

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other

Enumeration date
05/12/2020
Last updated
06/06/2024
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