Poudre Valley Medical Group, LLC

NPI #1699562181 in Walsenburg, Colorado

Provider Information

NPI Number: 1699562181
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 21, 2025
Last Updated: Apr 21, 2025

Practice Location

Address: 23500 US HIGHWAY 160
City: Walsenburg
State: Colorado
ZIP Code: 81089-9524
Phone: (719) 738-4588

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (719) 738-4588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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