Provider Demographics
NPI:1730254483
Name:ADVANCED PAIN THERAPEUTICS, PC
Entity type:Organization
Organization Name:ADVANCED PAIN THERAPEUTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:ENGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-340-5518
Mailing Address - Street 1:2305 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1522
Mailing Address - Country:US
Mailing Address - Phone:720-340-5518
Mailing Address - Fax:720-489-3799
Practice Address - Street 1:7809 W 38TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6183
Practice Address - Country:US
Practice Address - Phone:303-463-6000
Practice Address - Fax:303-463-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32563207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO66586348Medicaid
COC453358Medicare PIN
CO66586348Medicaid