Healthcare Provider Details
I. General information
NPI: 1023099371
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/11/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 S POTOMAC ST #225
AURORA CO
80012-4514
US
IV. Provider business mailing address
720 S COLORADO BLVD SUITE 220A
GLENDALE CO
80246-1912
US
V. Phone/Fax
- Phone: 303-873-5245
- Fax: 303-873-5240
- Phone: 303-584-8000
- Fax: 303-584-8141
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
E
KING
Title or Position: CEO
Credential:
Phone: 303-584-8000