MEDICARE: HEALTHONE CLINIC SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1043310097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHONE CLINIC SERVICES LLC

Provider Business Mailing Address
First Line	:	720 S COLORADO BLVD
Second Line	:	SUITE 220A
City	:	GLENDALE
State	:	CO
Zip	:	80246-1912
Country	:	US
Telephone Number	:	303-584-8231
Fax Number	:	303-584-8141

Provider Business Practice Location Address
First Line	:	701 E HAMPDEN AVE
Second Line	:	SUITE 510
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2776
Country	:	US
Telephone Number	:	303-788-9762
Fax Number	:	303-788-4801

Authorized Official
Title or Position	:	CEO
Name	:	MR. WILLIAM E KING
Credential	:
Telephone Number	:	303-584-8000

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	05/20/2008

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