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) 364-5250
Entity
Organization
Contact information
Practice address
3843 RIO VISTA DRIVE, SUITE 2100, COLORADO SPRINGS, CO 80917-3381
(719) 364-5250
(719) 364-5251
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
07/05/2023
Last updated
06/07/2024
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