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Organization

SOUTHERN COLORADO UROLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKY R JONES (CREDENTIALING OFFICER)
(719) 530-2016
Entity
Organization

Contact information

Practice address
550 W HWY 50, SALIDA, CO 81201-2238
(719) 530-2000
Mailing address
PO BOX 549, SALIDA, CO 81201-0549
(719) 530-2000

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17434
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01174341
CO
Enumeration date
11/16/2007
Last updated
11/16/2007
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