Provider Demographics
NPI:1902067481
Name:CHRISTOPHER H. HEALEY MD PC
Entity Type:Organization
Organization Name:CHRISTOPHER H. HEALEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:HEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-688-2320
Mailing Address - Street 1:1 OAKWOOD PARK PLZ
Mailing Address - Street 2:#101
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1882
Mailing Address - Country:US
Mailing Address - Phone:303-688-2320
Mailing Address - Fax:303-688-1371
Practice Address - Street 1:1 OAKWOOD PARK PLZ
Practice Address - Street 2:#101
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1882
Practice Address - Country:US
Practice Address - Phone:303-688-2320
Practice Address - Fax:303-688-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93404212Medicaid