Organization
MADISON STREET PROVIDER NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN GROSS (CREDENTIALING MANAGER)
(303) 586-9390
Entity
Organization
Contact information
Practice address
1421 S POTOMAC ST STE 130, AURORA, CO 80012-4511
(303) 377-2020
(303) 377-2022
Mailing address
PO BOX 912914, DENVER, CO 80291-2914
(303) 377-2020
(303) 377-2022
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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