Provider Demographics
NPI:1134174121
Name:OSTEOPATHIC ORTHOPEDICS PC
Entity type:Organization
Organization Name:OSTEOPATHIC ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-360-6003
Mailing Address - Street 1:9890 E POWERS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3546
Mailing Address - Country:US
Mailing Address - Phone:303-360-6003
Mailing Address - Fax:303-364-3314
Practice Address - Street 1:14111 E ALAMEDA AVE
Practice Address - Street 2:STE 200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2546
Practice Address - Country:US
Practice Address - Phone:303-360-6003
Practice Address - Fax:303-364-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04025086Medicaid
COC80504Medicare PIN