Organization
WESTERN MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY MANNING PICKETT MD (MEDICAL DIRECTOR STAFF PHYSICIAN)
(303) 232-3232
Entity
Organization
Contact information
Practice address
1805 KIPLING ST, LAKEWOOD, CO 80215
(303) 232-3232
(303) 232-3232
Mailing address
1805 KIPLING ST, LAKEWOOD, CO 80215
(303) 232-3232
(303) 232-8922
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18721
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004966
—
CO
Enumeration date
07/12/2007
Last updated
07/12/2007
Update your record
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