Organization · Type 2 NPI

Poudre Valley Medical Group, LLC

Surgery Physician · Pueblo, CO

NPI number 1720875289 Active

Practice location

525 W 15th St Ste 300
Pueblo, CO 81003-2716

Call (719) 542-1696 Map

Fax (719) 542-1698

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	None listed

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

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NPI record

NPI: 1720875289
Entity type: Organization (Type 2)
Issued: Apr 21, 2025
Last updated: Apr 21, 2025
Status: Active
Subpart: Yes of Poudre Valley Medical Group, LLC

Other names

Uchealth Medical Group · doing business as
Uchealth Breast Center - Pueblo · other name

Authorized official

Jana Conroy
Director of Credentialing
(719) 542-1696

Verify this record

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 1720875289

Poudre Valley Medical Group, LLC's National Provider Identifier is 1720875289, issued on Apr 21, 2025. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Pueblo, CO. The record was last updated on Apr 21, 2025.