Healthcare Provider Details

I. General information

NPI: 1003829565
Provider Name (Legal Business Name): PHILIP MICHAEL HENBEST D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9981 WASHINGTON ST SUITE 21
THORNTON CO
80229-2169
US

IV. Provider business mailing address

1930 S FEDERAL BLVD
DENVER CO
80219-5501
US

V. Phone/Fax

Practice location:
  • Phone: 303-252-0488
  • Fax: 303-252-1624
Mailing address:
  • Phone: 303-935-9142
  • Fax: 303-934-7332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25418
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: