Poudre Valley Medical Group, LLC

NPI #1619585312 in Lamar, Colorado

Provider Information

NPI Number: 1619585312
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: Jul 20, 2020
Last Updated: Aug 5, 2024

Practice Location

Address: 403 KENDALL DR
City: Lamar
State: Colorado
ZIP Code: 81052-3953
Phone: (719) 336-6790

Authorized Official

Name: JANA CONROY, MBA, RHIA
Title: DIRECTOR OF CREDENTIALING
Phone: (719) 336-6790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Cardiovascular Disease — Cardiovascular Disease	207RC0000X
Internal Medicine - Hematology & Oncology — Hematology & Oncology	207RH0003X
Clinic/Center	261Q00000X
General Practice	208D00000X	Primary

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