NPIMap

Organization Active NPI

Dermatology & Laser Center at Harvard Park, PLLC

Doing business as Dermatology & Laser Center

  • Dermatology Physician
  • Denver, CO
National Provider Identifier
1376645143
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY & LASER CENTER AT HARVARD PARK, PLLC
Doing business as
Dermatology & Laser Center
Practice address
950 E Harvard Ave
Ste 440
Denver, CO 80210-7009
Phone
(303) 744-2704
Fax
(303) 744-3244
NPI assigned
Sep 2, 2006
Last updated
May 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephen W Eubanks, M.D.
Title
Managing Partner
Phone
(303) 744-2704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

950 E Harvard Ave
Ste 440
Denver, CO 80210-7009

Mailing address

950 E Harvard Ave
Ste 440
Denver, CO 80210-7009
Phone (303) 744-2704

Other identifiers 3

IdentifierTypeStateIssuer
87557011MedicaidCO
DE635330OtherCOBCBS
CH4005OtherCORR MEDICARE

Other names 1

  • DERMATOLOGY & LASER CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

950 E Harvard Ave
Ste 440
Denver, CO 80210
Phone (303) 744-2404

950 E Harvard Ave
Ste 470
Denver, CO 80210
Phone (303) 744-2704

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1376645143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "STE 440",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107009",
            "telephone_number": "303-744-2704",
            "fax_number": "303-744-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "STE 440",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107009",
            "telephone_number": "303-744-2704",
            "fax_number": "303-744-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & LASER CENTER AT HARVARD PARK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "303-744-2704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87557011",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "DE635330",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH4005",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DERMATOLOGY & LASER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.