Provider Demographics
NPI:1053794461
Name:ORTHO ONE COLORADO, LLC
Entity type:Organization
Organization Name:ORTHO ONE COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:RAMSEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANTOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-390-3376
Mailing Address - Street 1:3501 S CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3916
Mailing Address - Country:US
Mailing Address - Phone:303-594-7102
Mailing Address - Fax:303-781-0004
Practice Address - Street 1:3501 S CLARKSON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3916
Practice Address - Country:US
Practice Address - Phone:303-594-7102
Practice Address - Fax:303-781-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty