Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 25292 | CO |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 25292 | CO |
NPI | 1417916198 |
---|---|
Provider Name | Kenton Voorhees |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 15/11/2018 |