CORWIN CLINIC SURGICAL PROFESSIONAL CORP NPI 1356492219

NPI Information

  • NPI: 1356492219
  • Provider Name: CORWIN CLINIC SURGICAL PROFESSIONAL CORP
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Other Name: CORWIN CLINIC SURGICAL, PC
  • Address: 1925 E ORMAN AVE STE A109
    PUEBLO, CO
    ZIP 81004
  • Phone: (719) 564-0210

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NPI Details

CORWIN CLINIC SURGICAL PROFESSIONAL CORP is a specialist in Pueblo, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CORWIN CLINIC SURGICAL PROFESSIONAL CORP NPI is 1356492219. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Corwin Clinic Surgical, Pc.

The provider's business location address is:

1925 E ORMAN AVE STE A109
PUEBLO, CO
ZIP 81004-555
Phone: (719) 564-0210
Fax: (719) 564-9483

The provider's authorized official is Gary E. Lane .
The authorized official title is President and has the following contact phone number (719) 564-0210.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 3/23/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CK9608MEDICARE ID-TYPE UNSPECIFIEDCOLORADOMEDICARE GROUP NUMBER
204011417MEDICAIDCOLORADO
3=========OTHERCOLORADOGROUP TAX ID NUMBER

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: 11/21/2025

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