Provider Demographics
NPI:1861972101
Name:FEHR, KENNETH C III
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:C
Last Name:FEHR
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7334 S CHAPPARAL CIR W
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2177
Mailing Address - Country:US
Mailing Address - Phone:303-589-5608
Mailing Address - Fax:888-907-0019
Practice Address - Street 1:7334 S CHAPPARAL CIR W
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80016-2177
Practice Address - Country:US
Practice Address - Phone:303-589-5608
Practice Address - Fax:888-907-0019
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83-0688166332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies