Poudre Valley Medical Group, LLC

NPI #1225742000 in Longmont, Colorado

Provider Information

NPI Number: 1225742000
Entity Type: Organization
Organization Name: Poudre Valley Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: POUDRE VALLEY MEDICAL GROUP, LLC
Primary Specialty: General Practice
Enumeration Date: Jan 6, 2023
Last Updated: Jul 12, 2024

Practice Location

Address: 1760 E KEN PRATT BLVD
Address 2: 1.220, 1.222
City: Longmont
State: Colorado
ZIP Code: 80504-5311
Phone: (720) 718-5140

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (720) 718-5140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Hospitalist	208M00000X
General Practice	208D00000X	Primary

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