Provider Demographics
NPI:1447846977
Name:ASSOCIATES OF OTOLARYNGOLOGY, P.C.
Entity type:Organization
Organization Name:ASSOCIATES OF OTOLARYNGOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-744-1961
Mailing Address - Street 1:850 E HARVARD AVE STE 505
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5078
Mailing Address - Country:US
Mailing Address - Phone:303-607-4134
Mailing Address - Fax:303-744-1154
Practice Address - Street 1:9980 PARK MEADOWS DR STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8406
Practice Address - Country:US
Practice Address - Phone:303-607-4134
Practice Address - Fax:303-744-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04957080Medicaid