Autumn Spirit PA, Inc

Organization Active NPI Neurological Surgery Physician · Lone Tree, CO

NPI 1497225841 · NPPES record last updated Nov 28, 2018

Key facts

NPI
1497225841
Entity type
Organization (NPI type 2)
Primary specialty
Neurological Surgery Physician 207T00000X
Legal business name
AUTUMN SPIRIT PA, INC
Practice address
10099 Ridgegate Pkwy
Lone Tree, CO 80124-5531
Phone
(303) 790-1800
Fax
(303) 790-1809
NPI assigned
Nov 28, 2018
Organization subpart
No

Authorized official

Name
Dr. Kevin Louis Boyer, MD
Title
Owner
Phone
(941) 920-7196

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207T00000X Yes

Addresses

Primary practice location

10099 Ridgegate Pkwy
Lone Tree, CO 80124-5531

Mailing address

9436 Hidden Pines CT
Parker, CO 80134-4545
Phone (941) 920-7196

Other identifiers

IdentifierTypeStateIssuer
9000152452MedicaidCO

Other providers in Lone Tree, CO

All providers in Lone Tree, CO · Neurological Surgery Physician in Colorado

Sources for this page

Verify at the official NPI Registry.