Organization
SOUTHERN COLORADO UROLOGY
Active
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
Update your record
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