Healthcare Provider Details

I. General information

NPI: 1275756561
Provider Name (Legal Business Name): REPRODUCTIVE GENETICS CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S HUDSON ST LEVEL III
DENVER CO
80246-1479
US

IV. Provider business mailing address

455 S HUDSON ST LEVEL III
DENVER CO
80246-1479
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-5393
  • Fax:
Mailing address:
  • Phone: 303-399-5393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number16829
License Number StateCO

VIII. Authorized Official

Name: DR. GEORGE P HENRY
Title or Position: OWNER PRESIDENT
Credential: M.D.
Phone: 303-399-5393