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Contact Information

DENVER NEUROLOGICAL CLINIC PROFESSIONAL LLC
9980 PARK MEADOWS DR STE 100
LONE TREE, CO80124-8404
 Phone: 303-715-9024
 Fax: 303-715-7057
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for DENVER NEUROLOGICAL CLINIC PROFESSIONAL LLC

NPI # 1578744017
LBN Legal business name DENVER NEUROLOGICAL CLINIC PROFESSIONAL LLC
Authorized official JUSTIN MOON - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/26/2007
Last updated 08/31/2023 - About 3 years ago
Identifiers
CO License # 42593
CO Medicaid 10733850
CO Other P00361949 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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