Organization
HEART & VASCULAR CLINIC OF NORTHERN COLORADO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE RICHARDSON (ADMINISTRATOR)
(970) 227-6931
Entity
Organization
Contact information
Practice address
2121 E HARMONY RD, UNIT 200, FORT COLLINS, CO 80528-3401
(970) 221-1000
(970) 221-1544
Mailing address
2121 E HARMONY RD, UNIT 200, FORT COLLINS, CO 80528-3401
(970) 221-1000
(970) 221-1544
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
CO
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
CO
207RI0011X
Interventional Cardiology Physician
—
CO
207UN0901X
Nuclear Cardiology Physician
—
CO
2086S0129X
Vascular Surgery Physician
—
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
CO
363LF0000X
Family Nurse Practitioner
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4892048
—
CO
01
—
HE89204
BCBS GROUP NUMBER
CO
Enumeration date
06/24/2005
Last updated
02/22/2008
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