Healthcare Provider Details

I. General information

NPI: 1427695881
Provider Name (Legal Business Name): REGENERATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12596 W BAYAUD AVE STE 205
LAKEWOOD CO
80228-2000
US

IV. Provider business mailing address

12596 W BAYAUD AVE STE 205
LAKEWOOD CO
80228-2000
US

V. Phone/Fax

Practice location:
  • Phone: 303-945-4790
  • Fax:
Mailing address:
  • Phone: 303-945-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ROBERT BROWN
Title or Position: PHYSICIAN
Credential: MD
Phone: 720-471-9500