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11750 W 2nd Pl Suite 365 Lakewood CO 80228-1575 | |
(720) 321-8280 | |
(720) 321-8281 |
Full Name | |
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Speciality | Internal Medicine |
Location | 11750 W 2nd Pl, Lakewood, Colorado |
Authorized Official Name and Position | Angela Skinner (OMA ADMINISTRATOR) |
Authorized Official Contact | 3036737175 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 911057 Denver CO 80291-1057 Ph: (303) 643-1099 | 11750 W 2nd Pl Suite 365 Lakewood CO 80228-1575 Ph: (720) 321-8280 |
NPI Number | 1164828026 |
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Provider Enumeration Date | 11/05/2014 |
Last Update Date | 04/20/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164828026 | NPI | - | NPPES |
53037375 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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