Organization
EDMOND GENERAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M SMITHAM (EXECUTIVE DIRECTOR)
(303) 584-8000
Entity
Organization
Contact information
Practice address
4900 S MONACO ST, #210, DENVER, CO 80237-3486
(303) 584-8000
(303) 584-8141
Mailing address
4900 S MONACO ST, #210, DENVER, CO 80237-3486
(303) 584-8000
(303) 584-8141
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200074050A
—
OK
Enumeration date
06/08/2006
Last updated
04/23/2012
Update your record
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