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Organization

INTERMOUNTAIN ANESTHESIA PROFESSIONAL CONSULTANTS, LLP

Active
Other names
Northern Colorado Pain Management
Organization subpart
No

Provider details

NPI number
Authorized official
JAN GILLESPIE MD (OWNER)
(970) 495-0300
Entity
Organization

Contact information

Practice address
1175 58TH AVE, STE 202, GREELEY, CO 80634-4807
(970) 495-0300
(970) 224-9624
Mailing address
1175 58TH AVE, STE 202, GREELEY, CO 80634-4807
(970) 495-0300
(970) 224-9624

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
CO
207L00000X
Anesthesiology Physician
207VG0400X
Gynecology Physician
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04018909
CO
05
112073500
WY
01
IM160808
ANTHEM BCBS
CO
Enumeration date
07/12/2005
Last updated
07/21/2022
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