Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Outreach Clinic - Lamar, UCHealth Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY MBA, RHIA (DIRECTOR OF CREDENTIALING)
(719) 336-6790
Entity
Organization
Contact information
Practice address
403 KENDALL DR, LAMAR, CO 81052-3953
(719) 336-6790
(719) 336-7026
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(719) 336-6790
(719) 336-7026
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
07/20/2020
Last updated
08/05/2024
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