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 (DIRECTOR OF CREDENTIALING)
(719) 364-4120
Entity
Organization
Contact information
Practice address
1400 E BOULDER ST STE 500, COLORADO SPRINGS, CO 80909-5533
(719) 364-4120
(719) 364-4121
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
08/09/2024
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