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NPI Code Detail

MEDICARE: HEALTHONE CLINIC SERVICES - PEDIATRIC SPECIALTIES LLC

MEDICARE: HEALTHONE CLINIC SERVICES - PEDIATRIC 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
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1619792314
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHONE CLINIC SERVICES - PEDIATRIC SPECIALTIES LLC
Provider Business Mailing Address
First Line : 2000 HEALTH PARK DR
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4692
Country : US
Telephone Number : 615-373-7406
Fax Number :
Provider Business Practice Location Address
First Line : 1601 E 19TH AVE STE 3500
Second Line :
City : DENVER
State : CO
Zip : 80218-1252
Country : US
Telephone Number : 303-790-1515
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : NICHOLAS F WADLINGTON
Credential :
Telephone Number : 972-401-9807
Provider Enumeration Date : 11/18/2024
Last Update Date : 11/18/2024

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

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