Provider Demographics
NPI:1053634196
Name:PHILIP M HENBEST DO PC
Entity Type:Organization
Organization Name:PHILIP M HENBEST DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENBEST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-252-0488
Mailing Address - Street 1:1930 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5501
Mailing Address - Country:US
Mailing Address - Phone:303-935-9142
Mailing Address - Fax:303-934-7332
Practice Address - Street 1:9981 N WASHINGTON ST
Practice Address - Street 2:SUITE 21
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2169
Practice Address - Country:US
Practice Address - Phone:303-252-0488
Practice Address - Fax:303-252-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25418261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01254184Medicaid
COCOA102567Medicare PIN