Evergreen Pediatrics, Llc
Pediatrics
Evergreen Pediatrics, Llc is a Evergreen, Colorado based Pediatric center with medical specialization in
General Pediatrics. Evergreen Pediatrics, Llc is doing business as
Evergreen Conifer Pediatrics.
It is located at
30960 Stagecoach Blvd, Suite W-120, Evergreen, Colorado - 80439-7902. They can be contacted on phone at
303-674-6671 and fax number 303-674-0031.
NPI number (Unique professional ID) for Evergreen Pediatrics, Llc is
1689839144 which was assigned by NPPES on 24 Jul, 2008 and it was last updated on 24 Jul, 2008.
Evergreen Pediatrics, Llc license number is
26133 for Pediatrics (208000000X) in Colorado.
Evergreen Pediatrics, Llc is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Evergreen Pediatrics, Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Evergreen Pediatrics, Llc |
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| Other Name : | Evergreen Conifer Pediatrics |
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Business Address:
Evergreen Pediatrics, Llc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 30960 Stagecoach Blvd, Suite W-120
Evergreen, CO, 80439-7902
United States |
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| Phone Number : | 303-674-6671 |
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| Fax Number : | 303-674-0031 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1689839144 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 24 Jul, 2008 |
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| Last Updated On : | 24 Jul, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Kennethjohn Kutalek |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | OWNER |
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| Phone Number : | 303-674-6671 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Evergreen Pediatrics, Llc are as mentioned. Primary taxonomy code for Evergreen Pediatrics, Llc is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 26133 | CO |
Legacy Identifiers:
Other legacy medical identifiers of Evergreen Pediatrics, Llc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 40308332 | MEDICAID | CO | |
| 04007977 | MEDICAID | CO | |
| 01261338 | MEDICAID | CO | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 30960 Stagecoach Blvd, Suite W-120
Evergreen, CO, 80439-7902
United States |
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| Phone Number : | 303-674-6671 |
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| Fax Number : | 303-674-0031 |
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Business Location:
Patients can refer following map for directions to
Evergreen Pediatrics, Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.