Provider Demographics
NPI:1528195542
Name:HUSS, PHYLLIS K
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:K
Last Name:HUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11343 W BERRY PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1847
Mailing Address - Country:US
Mailing Address - Phone:303-978-1944
Mailing Address - Fax:
Practice Address - Street 1:5257 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2228
Practice Address - Country:US
Practice Address - Phone:303-972-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
014377OtherKAISER-COMMERCIAL NUMBER