MEDICARE: MR. ROBERT ELLIS HENSON II MD

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	207RC0000X	Cardiovascular Disease Physician	MD60700596	WA
2	207RC0000X	Cardiovascular Disease Physician	30651	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104822121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT ELLIS HENSON II MD

Provider Business Mailing Address
First Line	:	5961 RAIN DANCE TRL
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-9095
Country	:	US
Telephone Number	:	720-255-4134
Fax Number	:	720-784-6183

Provider Business Practice Location Address
First Line	:	5961 RAIN DANCE TRL
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-9095
Country	:	US
Telephone Number	:	720-255-4134
Fax Number	:	720-784-6183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/10/2024

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