National Provider Identifier Database

POUDRE VALLEY MEDICAL GROUP LLC
Radiation Oncology

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.


Contact Information

POUDRE VALLEY MEDICAL GROUP, LLC
525 W 15TH ST STE 100
PUEBLO, CO81003-2716
Phone: 719-542-1680
Fax: 719-542-1681
Website:
Specialty Taxonomy Code
* Radiation Oncology 2085R0001X

* Indicates primary specialty

NPI Profile & details for POUDRE VALLEY MEDICAL GROUP, LLC

NPI Number 1265229728
Legal business name
LBN
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official JANA CONROY - (DIRECTOR OF CREDENTIALING)
Entity Organization
Organization subpart Yes
Enumeration date 04/21/2025
Last updated 04/21/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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