Poudre Valley Medical Group, LLC

NPI #1255127981 in Pueblo, Colorado

Provider Information

NPI Number: 1255127981
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: Urology
Enumeration Date: Apr 18, 2025
Last Updated: Apr 18, 2025

Practice Location

Address: 3676 PARKER BLVD STE 280
City: Pueblo
State: Colorado
ZIP Code: 81008-2213
Phone: (719) 542-1500

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (719) 595-8505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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