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PUEBLO EAR NOSE & THROAT SPECIALIST NPI 1306175484


NPI Information

NPI: 1306175484
Provider Name: PUEBLO EAR NOSE & THROAT SPECIALIST
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization
Address:
1218 PUEBLO BLVD WAY
PUEBLO, CO
ZIP 81005
Phone: (719) 566-1277
Get Directions

PUEBLO EAR NOSE & THROAT SPECIALIST is an otolaryngology in Pueblo, CO. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. PUEBLO EAR NOSE & THROAT SPECIALIST NPI is 1306175484. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1218 PUEBLO BLVD WAY
PUEBLO, CO
ZIP 81005-507
Phone: (719) 566-1277
Fax: (719) 566-1257

The provider's authorized official is Charlene Hickson .
The authorized official title is Owner and has the following contact phone number (719) 566-1277.

The enumeration date for this NPI number is 12/18/2009 and was last updated on 4/16/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1COA100059MEDICARE PINCOLORADO
274482581MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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