Basic Information
Provider Information
NPI: 1659450385
EntityType: 2
ReplacementNPI:  
OrganizationName: HEALTHONE CLINIC SERVICES LLS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ASPEN FAMILY MEDICINE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 720 S COLORADO BLVD
Address2: SUITE 220A
City: GLENDALE
State: CO
PostalCode: 802461912
CountryCode: US
TelephoneNumber: 3035848231
FaxNumber: 8662100907
Practice Location
Address1: 8101 E LOWRY BLVD
Address2: SUITE 250
City: DENVER
State: CO
PostalCode: 802307195
CountryCode: US
TelephoneNumber: 3033661986
FaxNumber: 3033666433
Other Information
ProviderEnumerationDate: 11/03/2006
LastUpdateDate: 05/20/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: KING
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 3035848231
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home