Organization · Type 2 NPI

Poudre Valley Medical Group, LLC

Radiation Oncology Physician · Colorado Springs, CO

NPI number 1104439322 Active

Practice location

525 Bob Peters Grv Ste 100
Colorado Springs, CO 80909-4533

Call (719) 365-6800 Map

Fax (719) 365-5740

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Specialties and licenses

Taxonomy	Code	License
Radiation Oncology Physician Primary	2085R0001X	None listed

Radiation Oncology Physician: A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

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NPI record

NPI: 1104439322
Entity type: Organization (Type 2)
Issued: Aug 27, 2020
Last updated: May 22, 2024
Status: Active
Subpart: Yes of Poudre Valley Medical Group, LLC

Other names

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Uchealth Medical Group · doing business as
Uchealth Radiation Oncology - Memorial Central · other name

Authorized official

Jana Conroy
Director of Credentialing
(719) 365-6800

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104439322

Poudre Valley Medical Group, LLC's National Provider Identifier is 1104439322, issued on Aug 27, 2020. The primary taxonomy on file is Radiation Oncology Physician (2085R0001X), and the practice location is in Colorado Springs, CO. The record was last updated on May 22, 2024.