Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
SCL Health Medical Group - Lafayette Womens Health (MFM, OBYN, Urogyn), Intermountain Health Lafayette Women's Clinic -Maternal Fetal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP OF FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
300 EXEMPLA CIR STE 470, LAFAYETTE, CO 80026-3396
(303) 673-1440
(303) 673-1360
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
(303) 272-0566
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
08/07/2023
Last updated
06/28/2024
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