Healthcare Provider Details

I. General information

NPI: 1881653111
Provider Name (Legal Business Name): SCOTT J. HOMPLAND D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 S BANNOCK ST #605
ENGLEWOOD CO
80110-2432
US

IV. Provider business mailing address

3333 S BANNOCK ST #605
ENGLEWOOD CO
80110-2432
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-9332
  • Fax: 303-788-9335
Mailing address:
  • Phone: 303-788-9332
  • Fax: 303-788-9335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number28824
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: