Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 28389 | CO |
NPI | 1265494660 |
---|---|
Provider Name | Dr. Kent D Heyborne |
First Address | Denver, CO 80218-1216 |
Second Address | Denver, CO 80218-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01283894 | (05) | CO |
F20337 | (02) | CO |