John F Wolz MD Prof LLC

Key facts

NPI

1508058710

Entity type

Organization (NPI type 2)

Primary specialty

Surgical Critical Care Physician 2086S0102X

License

AW424346 (CO)

Legal business name

JOHN F WOLZ MD PROF LLC

Practice address

625 W Platte Ave
Fort Morgan, CO 80701-2669

Phone

(970) 867-4916

Fax

(970) 867-8659

NPI assigned

Aug 11, 2007

Organization subpart

No

Authorized official

Name

Mrs. Linda Jackson

Title

Office Manager

Phone

(970) 867-4916

National Provider Directory

Specialties & licenses

Addresses

Other names

• Colorado Emergency Surgery Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 17, 2008.

{
    "created_epoch": "1186790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1508058710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 799",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807010799",
            "telephone_number": "970-867-4916",
            "fax_number": "970-867-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W PLATTE AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807012669",
            "telephone_number": "970-867-4916",
            "fax_number": "970-867-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN F WOLZ MD PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-11",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-867-4916",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CO",
            "license": "AW424346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Emergency Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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