Provider Demographics
NPI:1194907055
Name:PAUL W ORTON
Entity type:Organization
Organization Name:PAUL W ORTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-791-0410
Mailing Address - Street 1:7336 S YOSEMITE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2340
Mailing Address - Country:US
Mailing Address - Phone:303-791-0410
Mailing Address - Fax:303-791-4548
Practice Address - Street 1:7336 S YOSEMITE ST STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2340
Practice Address - Country:US
Practice Address - Phone:303-791-0410
Practice Address - Fax:303-791-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCM4908Medicare UPIN