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NPI Code Detail

MEDICARE: HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC

MEDICARE: HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES 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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1275144008
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC
Provider Business Mailing Address
First Line : 2000 HEALTH PARK DR
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4525
Country : US
Telephone Number : 615-372-5426
Fax Number :
Provider Business Practice Location Address
First Line : 1919 E 18TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80206-1107
Country : US
Telephone Number : 303-322-3993
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : WILLIAM M SMITHAM
Credential :
Telephone Number : 303-584-8119
Provider Enumeration Date : 08/14/2020
Last Update Date : 08/14/2020

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Directions to “HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC ” Practice Location

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