Healthcare Provider Details
I. General information
NPI: 1376374348
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES - OBSTETRICS AND GYNECOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4600 E 9TH AVE STE 250
DENVER CO
80220-4042
US
IV. Provider business mailing address
2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US
V. Phone/Fax
- Phone: 303-320-8490
- Fax:
- Phone: 615-373-7406
- Fax:
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:
NICHOLAS
F
WADLINGTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 972-401-9807