Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Lafayette Women's Clinic - Comprehensive Breast Care, Lafayette Clinic Diabetes & Endocrinology, Lafayette Clinic Urogynecology, Lafayette Clinic OB/GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE MEDICAL GROUP)
(303) 272-0231
Entity
Organization
Contact information
Practice address
300 EXEMPLA CIR STE 300, LAFAYETTE, CO 80026-3394
(303) 318-3220
(303) 318-3219
Mailing address
300 EXEMPLA CIR, LAFAYETTE, CO 80026-3397
(303) 318-3220
(303) 318-3219
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
06/28/2024
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