Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 22327 | CO |
N | 111NI0900X | Internist | 22327 | CO |
Y | 207RP1001X | Pulmonary Disease | 22327 | CO |
N | 207RS0012X | Sleep Medicine | DR.0022327 | CO |
NPI | 1376504670 |
---|---|
Provider Name | Dr. Kenneth Hooper Weisiger |
First Address | Lakewood, CO 80401-3187 |
Second Address | Lakewood, CO 80401-3187 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 09/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1223270 | (05) | CO |
C305318 | MEDICARE PTAN (01) | CO |
E88668 | (02) | CO |