Provider Demographics
NPI:1275740508
Name:DENVER ONCOLOGY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DENVER ONCOLOGY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-778-5714
Mailing Address - Street 1:PO BOX 910779
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-0779
Mailing Address - Country:US
Mailing Address - Phone:303-778-5714
Mailing Address - Fax:303-778-5293
Practice Address - Street 1:2555 S. DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210
Practice Address - Country:US
Practice Address - Phone:303-778-5714
Practice Address - Fax:303-778-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO318002085R0001X
2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01318021Medicaid
C174308Medicare PIN
COC174308Medicare PIN
COF29849174308Medicare UPIN