Provider Demographics
NPI:1588766562
Name:HEPWORTH, EDWARD JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JAMES
Last Name:HEPWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 E 3RD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5247
Mailing Address - Country:US
Mailing Address - Phone:720-899-9489
Mailing Address - Fax:720-953-5151
Practice Address - Street 1:3150 E 3RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:720-899-9489
Practice Address - Fax:303-953-5151
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR43375207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO78182239Medicaid
CAA86999OtherSTATE
CODR43375OtherSTATE
CODR43375OtherSTATE
CODR43375OtherSTATE
CO78182239Medicaid