Provider Demographics
NPI:1003892670
Name:ENGEN, PHILLIP L (MD)
Entity Type:Individual
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First Name:PHILLIP
Middle Name:L
Last Name:ENGEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2305 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1522
Mailing Address - Country:US
Mailing Address - Phone:720-340-5518
Mailing Address - Fax:720-489-3799
Practice Address - Street 1:7809 W 38TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6109
Practice Address - Country:US
Practice Address - Phone:303-463-6000
Practice Address - Fax:303-463-6001
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2017-04-01
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Provider Licenses
StateLicense IDTaxonomies
CO32563207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01325638Medicaid
COF55324Medicare UPIN
COC453358Medicare PIN