Provider Demographics
NPI:1134390008
Name:DR. KEVIN P. NOFFSINGER P.C.
Entity type:Organization
Organization Name:DR. KEVIN P. NOFFSINGER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NOFFSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-873-1116
Mailing Address - Street 1:10200 E GIRARD AVE
Mailing Address - Street 2:SUITE C-147
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5500
Mailing Address - Country:US
Mailing Address - Phone:303-873-1116
Mailing Address - Fax:303-873-1118
Practice Address - Street 1:10200 E GIRARD AVE
Practice Address - Street 2:SUITE C-147
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5500
Practice Address - Country:US
Practice Address - Phone:303-873-1116
Practice Address - Fax:303-873-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800187Medicare PIN