Basic Information
Provider Information
NPI: 1528160389
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PHILPOTT
FirstName: OSGOODE
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 950 E HARVARD AVE
Address2: STE 440
City: DENVER
State: CO
PostalCode: 802107009
CountryCode: US
TelephoneNumber: 3037442704
FaxNumber: 3037443244
Practice Location
Address1: 950 E HARVARD AVE
Address2: STE 440
City: DENVER
State: CO
PostalCode: 802107009
CountryCode: US
TelephoneNumber: 3037442704
FaxNumber: 3037443244
Other Information
ProviderEnumerationDate: 09/02/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X13820COY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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