Healthcare Provider Details

I. General information

NPI: 1588766562
Provider Name (Legal Business Name): EDWARD JAMES HEPWORTH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 E 3RD AVE STE 300
DENVER CO
80206
US

IV. Provider business mailing address

3150 E 3RD AVE STE 300
DENVER CO
80206-5247
US

V. Phone/Fax

Practice location:
  • Phone: 720-899-9489
  • Fax: 303-953-5151
Mailing address:
  • Phone: 720-899-9489
  • Fax: 720-953-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberDR43375
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: