Organization
PEDIATRICS WEST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYM C JOHNSON MBA (PRACTICE ADMINISTRATOR)
(720) 284-3708
Entity
Organization
Contact information
Practice address
3555 LUTHERAN PARKWAY, SUITE 200, WHEAT RIDGE, CO 80033-6027
(720) 284-3700
(303) 467-0525
Mailing address
3555 LUTHERAN PARKWAY, SUITE 200, WHEAT RIDGE, CO 80033-6027
(720) 284-3700
(303) 467-0525
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08683778
—
CO
Enumeration date
07/14/2006
Last updated
06/12/2020
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