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General NPI Number Information
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NPI Number | 1235460908
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Entity Type | Organization
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Legal Business Name | HGD SURGICAL PA SERVICES, INC.
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 11378 W RADCLIFFE DR
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City | LITTLETON
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State | CO
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Zip | 80127-1077
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Country | US
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Telephone | 303-257-4224
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Fax | 303-932-0480
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Provider Business Mailing Address
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Address Line | 11378 W RADCLIFFE DR
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City | LITTLETON
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State | CO
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Zip | 80127-1077
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Country | US
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Telephone | 303-257-4224
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Fax | 303-932-0480
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | HELENE G DESMARAIS
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Credential | PA-C
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Telephone | 303-257-4224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1582
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License Number State | CO
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