Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Lafayette Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
2600 CAMPUS DR STE A, LAFAYETTE, CO 80026-3358
(303) 673-1900
(303) 673-1915
Mailing address
500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
(303) 272-0566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
08/28/2020
Last updated
06/28/2024
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