Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25418 | CO |
NPI | 1003829565 |
---|---|
Provider Name | Dr. Philip Michael Henbest |
First Address | Denver, CO 80219-5501 |
Second Address | Thornton, CO 80229-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 18/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01254184 | (05) | CO |
D28369 | (02) |