Basic Information
| Provider Information | |||||||||
| NPI: | 1689746380 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHONE CLINIC SERVICES LLC | ||||||||
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| OtherOrganizationName: | CENTER FOR MEDICAL PAIN MANAGEMENT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 W HAMPDEN AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801102165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035848231 | ||||||||
| FaxNumber: | 8662100907 | ||||||||
| Practice Location | |||||||||
| Address1: | 1721 E 19TH AVE | ||||||||
| Address2: | SUITE 454 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035848125 | ||||||||
| FaxNumber: | 3035848141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DORSEY | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3035848231 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.