Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 29069 | CO |
NPI | 1003989856 |
---|---|
Provider Name | Dr. Clifford Scott Howe |
First Address | Pueblo, CO 81003-2657 |
Second Address | Pueblo, CO 81003-2657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 04/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01290691 | (05) | CO |
040003049 | RAILROAD MEDICARE (01) | |
E32813 | (02) | |
H043581 | ANTHEM BC BS (01) | CO |