Healthcare Provider Details

I. General information

NPI: 1083323109
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2022
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 420
DENVER CO
80220-3904
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2121
  • Fax:
Mailing address:
  • Phone: 615-372-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM M SMITHAM
Title or Position: VICE PRESIDENT
Credential:
Phone: 303-584-8119