Provider Demographics
NPI:1760187793
Name:HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC
Entity Type:Organization
Organization Name:HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-584-8119
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7406
Mailing Address - Fax:
Practice Address - Street 1:111 6TH ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-2002
Practice Address - Country:US
Practice Address - Phone:303-225-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHONE CLINIC SERVICES-SURGICAL SPECIALTIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty