Healthcare Provider Details

I. General information

NPI: 1598790198
Provider Name (Legal Business Name): MARK C WINSLOW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8158 E 5TH AVE STE 220
DENVER CO
80230-7306
US

IV. Provider business mailing address

9259 STAR STREAK CIR
LITTLETON CO
80125-1891
US

V. Phone/Fax

Practice location:
  • Phone: 303-856-3568
  • Fax: 303-648-5709
Mailing address:
  • Phone: 303-856-3568
  • Fax: 303-648-5709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number34745
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0320000502
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34745
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0034745
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: