Healthcare Provider Details

I. General information

NPI: 1649207002
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-584-8000
  • Fax: 303-584-8141
Mailing address:
  • Phone: 303-584-8000
  • Fax: 303-584-8141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM M SMITHAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-584-8000