Organization
BOULDER VALLEY THORACIC AND CARDIOVASCULAR SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK B DOUTHIT M.D. (PRESIDENT)
(303) 652-8888
Entity
Organization
Contact information
Practice address
6800 N 79TH ST, SUITE # 203, LONGMONT, CO 80503-7042
(303) 652-8888
(303) 652-2720
Mailing address
6800 N 79TH ST, SUITE # 203, LONGMONT, CO 80503-7042
(303) 652-8888
(303) 652-2720
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33880280
—
CO
Enumeration date
11/02/2006
Last updated
01/22/2008
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