Healthcare Provider Details
I. General information
NPI: 1023051034
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2006
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
- Phone: 303-584-8000
- Fax: 303-584-8141
- Phone: 303-584-8000
- Fax: 303-584-8141
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
M
SMITHAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-584-8000