Provider Demographics
NPI:1730503350
Name:COLUMBINE & FLATIRONS DERMATOLOGY ASSOCIATES
Entity type:Organization
Organization Name:COLUMBINE & FLATIRONS DERMATOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-898-9410
Mailing Address - Street 1:14534 FENTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-6113
Mailing Address - Country:US
Mailing Address - Phone:303-898-9410
Mailing Address - Fax:303-468-8793
Practice Address - Street 1:90 HEALTH PARK DR
Practice Address - Street 2:SUITE 390
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9757
Practice Address - Country:US
Practice Address - Phone:303-898-9410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36147207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1952393829OtherPERSONAL NPI
COG48104Medicare UPIN
COC806821Medicare PIN