Provider Demographics
NPI:1871914721
Name:ROCKY MOUNTAIN MEDICAL GROUP P.C.
Entity type:Organization
Organization Name:ROCKY MOUNTAIN MEDICAL GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-762-0900
Mailing Address - Street 1:4348 WOODLANDS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2814
Mailing Address - Country:US
Mailing Address - Phone:303-997-7546
Mailing Address - Fax:303-762-9072
Practice Address - Street 1:10700 E GEDDES AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3800
Practice Address - Country:US
Practice Address - Phone:303-428-3476
Practice Address - Fax:303-762-9072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty