Organization
FRONT RANGE DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AARON Z HOOVER MD (OWNER)
(970) 673-1155
Entity
Organization
Contact information
Practice address
6801 WEST 20TH, SUITE 208, GREELEY, CO 80634
(970) 673-1155
(970) 673-4747
Mailing address
PO BOX 69, TIMNATH, CO 80547
(970) 673-1155
(970) 673-4747
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
49733
CO
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45021023
—
CO
01
—
COAAA3047
MEDICARE PTAN
CO
Enumeration date
08/29/2012
Last updated
06/30/2020
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