William Eaves Lecoq, PA
Individual provider Active NPI Physician Assistant · Denver, CO
NPI 1831160050 · NPPES record last updated Aug 30, 2010
Key facts
- NPI
- 1831160050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1511 (CO)
- Practice address
- 4500 W. 38TH Ave.
Suite 220
Denver, CO 80212-2005 - Phone
- (303) 420-1297
- Fax
- (303) 420-2953
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040722000113 | CO | Practitioner - Physician Assistant | 0941280887 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1511 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Littleton | Past | Accepting new patients | |
| Radiology Imaging of Nebraska, LLC | Past | Accepting new patients | |
| Usacs of Colorado Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1511 | CO | Yes |
Addresses
Primary practice location
4500 W. 38TH Ave.
Suite 220
Denver, CO 80212-2005
Mailing address
4500 W. 38TH Ave.
Suite 220
Denver, CO 80212-2005
Phone (303) 420-1297
Other providers in Denver, CO
- Kimberly Lebrun
- Juan Martin Lecea Jr.
- Jessica Lynn Lechman
- Helana A Lechner
- Caroline Leclair
- Carol A Lecroy
- Jaime Lecuyer
- Haley Nichole Ledbetter
- Leder Internal Medicine Associates PC
- Lois Leder
All providers in Denver, CO · Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.