Provider Demographics
NPI:1053731455
Name:PINNACLE ORTHOPEDIC ALLIANCE, PC
Entity type:Organization
Organization Name:PINNACLE ORTHOPEDIC ALLIANCE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIGN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-473-3332
Mailing Address - Street 1:4105 BRIARGATE PARKWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3487
Mailing Address - Country:US
Mailing Address - Phone:719-473-3332
Mailing Address - Fax:719-368-6870
Practice Address - Street 1:4105 BRIARGATE PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3487
Practice Address - Country:US
Practice Address - Phone:719-473-3332
Practice Address - Fax:719-368-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20141244706207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty