Provider Demographics
NPI:1225391766
Name:COLORADO PAIN CONSULTANTS, LLC
Entity type:Organization
Organization Name:COLORADO PAIN CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FILLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-979-8229
Mailing Address - Street 1:5975 S QUEBEC ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4564
Mailing Address - Country:US
Mailing Address - Phone:303-792-2959
Mailing Address - Fax:303-792-2969
Practice Address - Street 1:5975 S QUEBEC ST
Practice Address - Street 2:SUITE 150
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4564
Practice Address - Country:US
Practice Address - Phone:303-792-2959
Practice Address - Fax:303-792-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2014-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO370512081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH46194Medicare UPIN