Healthcare Provider Details

I. General information

NPI: 1982685251
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E HAMPDEN AVE
ENGLEWOOD CO
80113-2546
US

IV. Provider business mailing address

720 S. COLORADO BLVD SUITE 220A
GLENDALE CO
80246-1912
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-9292
  • Fax: 303-788-9260
Mailing address:
  • Phone: 303-788-9292
  • Fax: 303-788-9260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BILLY KING
Title or Position: CEO
Credential:
Phone: 303-584-8000