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General NPI Number Information
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NPI Number | 1770541336
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Entity Type | Individual
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Provider Name | WILLIAM LEE DENAM JR. DO
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 417 S. TEJON ST. SUITE 120
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2206
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Country | US
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Telephone | 719-301-6417
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Fax |
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Provider Business Mailing Address
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Address Line | 1332 N WEBER ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2428
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Country | US
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Telephone | 719-491-1616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 39236
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0039236
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License Number State | CO
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