Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Lafayette Clinic - Trauma Surgery, Lafayette Clinic - General Surgery
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
300 EXEMPLA CIR STE 400, LAFAYETTE, CO 80026-3396
(303) 689-6560
(303) 689-6550
Mailing address
500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
(303) 272-0566
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
06/28/2024
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