Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 30954 | CO |
NPI | 1194765008 |
---|---|
Provider Name | Philip Heyman |
First Address | Englewood, CO 80113-3781 |
Second Address | Englewood, CO 80113-3781 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 13/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01309541 | (05) | CO |
E65694 | (02) | CO |