Provider Demographics
NPI:1194697458
Name:COAL CREEK FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:COAL CREEK FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:LIEF
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-673-1280
Mailing Address - Street 1:1044 S 88TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9445
Mailing Address - Country:US
Mailing Address - Phone:303-666-7119
Mailing Address - Fax:303-666-5995
Practice Address - Street 1:1044 S 88TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9445
Practice Address - Country:US
Practice Address - Phone:303-666-7119
Practice Address - Fax:303-666-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty