Organization
BOULDER RADIOLOGISTS INC P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER NICHOLS II M.D. (PRESIDENT)
(303) 473-7500
Entity
Organization
Contact information
Practice address
4747 ARAPAHOE AVE, BOULDER, CO 80303-1131
(303) 473-7500
(303) 440-2168
Mailing address
42 GARDEN CTR, BROOMFIELD, CO 80020-1730
(303) 465-0401
(303) 438-1351
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04995049
—
CO
01
—
CS6650
MEDICARE RAILROAD
CO
Enumeration date
03/29/2006
Last updated
03/15/2021
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