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General NPI Number Information
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NPI Number | 1376645143
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY & LASER CENTER AT HARVARD PARK, PLLC
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 950 E HARVARD AVE STE 440
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City | DENVER
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State | CO
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Zip | 80210-7009
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Country | US
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Telephone | 303-744-2704
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Fax | 303-744-3244
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Provider Business Mailing Address
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Address Line | 950 E HARVARD AVE STE 440
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City | DENVER
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State | CO
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Zip | 80210-7009
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Country | US
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Telephone | 303-744-2704
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Fax | 303-744-3244
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. STEPHEN W EUBANKS
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Credential | M.D.
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Telephone | 303-744-2704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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