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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Specialty Care Clinic - Canon City, 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) 562-2900
Entity
Organization

Contact information

Practice address
109 LATIGO LN STE E, CANON CITY, CO 81212-8113
(719) 562-2900
(719) 924-1592
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RG0100X
Gastroenterology Physician
207RP1001X
Pulmonary Disease Physician
2086S0129X
Vascular Surgery Physician

Other

Enumeration date
04/21/2025
Last updated
05/19/2025
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