MEDICARE: DR. PHILIP JUSTIN YORK M.D.

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	DR.0054804	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1790028041	OTHER	CO	PHYSICIAN PRACTICE - PHILIP YORK

General Provider Information

NPI Number	:	1790028041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP JUSTIN YORK M.D.

Provider Business Mailing Address
First Line	:	5958 S HOLLY ST
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-4221
Country	:	US
Telephone Number	:	303-214-1055
Fax Number	:	303-214-1055

Provider Business Practice Location Address
First Line	:	5958 S HOLLY ST
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-4221
Country	:	US
Telephone Number	:	303-214-1055
Fax Number	:	303-214-1055

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

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	07/11/2024

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