Provider Demographics
NPI:1306477534
Name:SURGONE, PC
Entity type:Organization
Organization Name:SURGONE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:UHERNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:303-957-1310
Mailing Address - Street 1:8490 E CRESCENT PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2815
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:303-761-4252
Practice Address - Street 1:2535 S DOWNING ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5851
Practice Address - Country:US
Practice Address - Phone:303-788-8989
Practice Address - Fax:303-788-8982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGONE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-27
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty