Kevin Leonard Mcclintock
Emergency Physician Family Doctor - Hospice and Palliative Medicine
1207 Pueblo Boulevard Way
Pueblo
, Colorado 81005-2175
Kevin Leonard Mcclintock
Emergency Physician Family Doctor - Hospice and Palliative Medicine
1207 Pueblo Boulevard Way
Pueblo
, Colorado 81005-2175
(719) 846-3133
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About
Features
Specialties
- Emergency Physician
- Family Doctor - Hospice and Palliative Medicine
Languages spoken
- English
Location
First Address
- Kevin Leonard Mcclintock
- 801 West Colorado Ave
- Trinidad, CO
- Zip : 81082-1319
- Phone : (719) 846-3133
Second Address
- Kevin Leonard Mcclintock
- 1207 Pueblo Boulevard Way
- Pueblo, CO
- Zip : 81005-2175
- Fax : (719) 542-1413
- Phone : (195) 420-0327
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 35456 | CO |
| Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DR.0035456 | CO |
National Provider Identifier
| NPI | 1366400178 |
|---|---|
| Provider Name | Kevin Leonard Mcclintock |
| First Address | Trinidad, CO 81082-1319 |
| Second Address | Pueblo, CO 81005-2175 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/05/2006 |
| Last Update Date | 14/02/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01354562 | (05) | CO |
| G72829 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.