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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group, UCHealth Cardiothoracic Surgery Clinic - Loveland
Organization subpart
Yes

Provider details

NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(970) 221-1000
Entity
Organization

Contact information

Practice address
2500 ROCKY MOUNTAIN AVE STE 360, LOVELAND, CO 80538-9004
(970) 221-1000
(970) 624-1892
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician

Other

Enumeration date
01/12/2023
Last updated
06/11/2024
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