Provider Demographics
NPI:1447457718
Name:ROCKY MOUNTAIN ENDOCRINE CONSULTANTS PC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN ENDOCRINE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:IZON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-295-0010
Mailing Address - Street 1:2121 E HARMONY RD
Mailing Address - Street 2:STE 300
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3400
Mailing Address - Country:US
Mailing Address - Phone:970-295-0010
Mailing Address - Fax:
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:STE 300
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-295-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41973321Medicaid
NE10025517900Medicaid
CODN9069OtherRR MEDICARE
WY126644600Medicaid
CO41973321Medicaid