Provider Demographics
NPI:1538253422
Name:ROCKY MOUNTAIN SURGICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ROCKY MOUNTAIN SURGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-388-2922
Mailing Address - Street 1:4545 E 9TH AVE
Mailing Address - Street 2:STE 460
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3901
Mailing Address - Country:US
Mailing Address - Phone:303-388-2922
Mailing Address - Fax:303-388-2962
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:STE 460
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:303-388-2922
Practice Address - Fax:303-388-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04695045Medicaid
CO04695045Medicaid