Healthcare Provider Details
I. General information
NPI: 1881406148
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES - SURGERY NEUROLOGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6179 S BALSAM WAY STE 230
LITTLETON CO
80123-3095
US
IV. Provider business mailing address
2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US
V. Phone/Fax
- Phone: 303-218-4260
- Fax:
- Phone: 615-373-7406
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
WADLINGTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 972-401-9807