Healthcare Provider Details

I. General information

NPI: 1124603816
Provider Name (Legal Business Name): CUTANEOUS ONCOLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2021
Last Update Date: 03/14/2021
Certification Date: 03/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE STE 3550
DENVER CO
80218-1285
US

IV. Provider business mailing address

499 E HAMPDEN AVE STE 130
ENGLEWOOD CO
80113-2791
US

V. Phone/Fax

Practice location:
  • Phone: 720-316-8091
  • Fax: 833-979-0946
Mailing address:
  • Phone: 720-316-8091
  • Fax: 833-979-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN M WEIGHT
Title or Position: OWNER/MEMBER
Credential: DO, MS
Phone: 720-316-8091