Provider Demographics
NPI:1063386225
Name:COLORADO WEST OTOLARYNGOLOGISTS PC
Entity type:Organization
Organization Name:COLORADO WEST OTOLARYNGOLOGISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MCKAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-245-2400
Mailing Address - Street 1:2515 FORESIGHT CIR UNIT 200
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1156
Mailing Address - Country:US
Mailing Address - Phone:970-245-2400
Mailing Address - Fax:970-242-9092
Practice Address - Street 1:233 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-4400
Practice Address - Country:US
Practice Address - Phone:970-245-2400
Practice Address - Fax:970-242-9092
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO WEST OTOLARYNGOLOGISTS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty