Healthcare Provider Details

I. General information

NPI: 1891029385
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES - OTOLARYNGOLOGY SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S POTOMAC ST STE 240
AURORA CO
80012-4541
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 303-750-8600
  • Fax:
Mailing address:
  • Phone: 615-372-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN REBOK
Title or Position: VP
Credential:
Phone: 615-372-5004