Organization
BOULDER VALLEY PLASTIC SURGERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY T. SWAIL M. D. (PRESIDENT)
(303) 449-6666
Entity
Organization
Contact information
Practice address
2575 PEARL ST., SUITE 300, BOULDER, CO 80302
(303) 449-6666
(303) 449-7023
Mailing address
2575 PEARL ST., SUITE 300, BOULDER, CO 80302
(303) 449-6666
(303) 449-7023
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
34276
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01342765
—
CO
01
—
SW88401
B/C AND B/S PROVIDER ID
CO
Enumeration date
10/20/2006
Last updated
07/22/2014
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