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NPI Code Detail

MEDICARE: PHYSICIAN HOUSECALLS LLC

MEDICARE: PHYSICIAN HOUSECALLS 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
1207R00000XInternal Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DE1013OTHERCORR MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1295789824
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN HOUSECALLS LLC
Provider Business Mailing Address
First Line : 12600 W COLFAX AVE STE B200
Second Line :
City : LAKEWOOD
State : CO
Zip : 80215-3736
Country : US
Telephone Number : 720-923-1250
Fax Number :
Provider Business Practice Location Address
First Line : 12600 W COLFAX AVE STE B200
Second Line :
City : LAKEWOOD
State : CO
Zip : 80215-3736
Country : US
Telephone Number : 720-923-1250
Fax Number : 303-284-4082
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : DEBRA KAY MOON-WADELTON
Credential :
Telephone Number : 720-923-1250
Provider Enumeration Date : 05/19/2006
Last Update Date : 03/23/2026

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Directions to “PHYSICIAN HOUSECALLS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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