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NPI Code Detail

MEDICARE: HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, LLC

MEDICARE: HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, 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
12083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number : 1619547783
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, LLC
Provider Business Mailing Address
First Line : PO BOX 645743
Second Line :
City : CINCINNATI
State : OH
Zip : 45264-6018
Country : US
Telephone Number : 855-689-5105
Fax Number : 904-446-3032
Provider Business Practice Location Address
First Line : 990 E HARVARD AVE
Second Line :
City : DENVER
State : CO
Zip : 80210-7008
Country : US
Telephone Number : 303-778-5242
Fax Number :
Authorized Official
Title or Position : CEO
Name : FRANK WILLIAMS
Credential :
Telephone Number : 904-446-3519
Provider Enumeration Date : 06/30/2021
Last Update Date : 06/01/2023

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Directions to “HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, LLC ” Practice Location

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