Provider Demographics
NPI:1740685023
Name:ROBERT R GREENHECK, M.D.
Entity type:Organization
Organization Name:ROBERT R GREENHECK, M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENHECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-755-5789
Mailing Address - Street 1:18962 E KANSAS DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4513
Mailing Address - Country:US
Mailing Address - Phone:303-755-5789
Mailing Address - Fax:
Practice Address - Street 1:18962 E KANSAS DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4513
Practice Address - Country:US
Practice Address - Phone:303-755-5789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17487261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care