Provider Demographics
NPI:1053542506
Name:COLORADO REPRODUCTIVE ENDOCRINOLOGY, P.C.
Entity type:Organization
Organization Name:COLORADO REPRODUCTIVE ENDOCRINOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-321-7115
Mailing Address - Street 1:4600 E. HALE PARKWAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-321-7115
Mailing Address - Fax:303-321-9519
Practice Address - Street 1:4600 E. HALE PARKWAY
Practice Address - Street 2:SUITE 350
Practice Address - City:DEVNER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-321-7115
Practice Address - Fax:303-321-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41047207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty