Provider Demographics
NPI:1073300794
Name:PIKES PEAK ENT
Entity type:Organization
Organization Name:PIKES PEAK ENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:WILHELM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-301-3800
Mailing Address - Street 1:9475 BRIAR VILLAGE PT STE 225
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7919
Mailing Address - Country:US
Mailing Address - Phone:719-301-3800
Mailing Address - Fax:719-301-3855
Practice Address - Street 1:1625 MEDICAL CENTER PT STE 230
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5748
Practice Address - Country:US
Practice Address - Phone:719-301-3800
Practice Address - Fax:719-301-3855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIKES PEAK ENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty