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Contact Information

SURGICAL SPECIALISTS OF COLORADO PLLC
10103 RIDGEGATE PKWY STE 309
LONE TREE, CO80124-5525
 Phone: 720-616-7835
 Fax: 303-736-4226
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for SURGICAL SPECIALISTS OF COLORADO PLLC

NPI Number 1487026951
LBN Legal business name SURGICAL SPECIALISTS OF COLORADO PLLC
Authorized official JACQUELYN GLENN - (OWNER/OPERATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2015
Last updated 04/08/2026 - About 2 months ago
Identifiers
CO License # DR47517
CO Medicaid 9000171312
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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