Organization
COMMUNITY MEDICAL GROUP, LLC
Active
Other names
Grand Valley Specialty Care, Grand Valley Vascular, Grand Valley Interventional Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN THOMAS (PRESIDENT AND CEO)
(970) 644-3011
Entity
Organization
Contact information
Practice address
2373 G RD STE 160, GRAND JUNCTION, CO 81505-1003
(970) 644-3840
(970) 644-3916
Mailing address
PO BOX 1727, GRAND JUNCTION, CO 81502-1727
(970) 263-2619
(970) 263-2691
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326471129
—
CO
Enumeration date
08/15/2013
Last updated
06/29/2020
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