Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
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)
(970) 586-2343
Entity
Organization
Contact information
Practice address
131 STANLEY AVE STE 202, ESTES PARK, CO 80517-6356
(970) 586-2343
(970) 586-9060
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 586-2343
(970) 586-9060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01657356
—
CO
Enumeration date
02/04/2019
Last updated
08/08/2024
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