Provider Demographics
NPI:1063855195
Name:CLARKINSON, ERIN GRAY (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:GRAY
Last Name:CLARKINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 MAIN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5170
Mailing Address - Country:US
Mailing Address - Phone:970-422-8147
Mailing Address - Fax:
Practice Address - Street 1:1199 MAIN AVE STE 206
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5170
Practice Address - Country:US
Practice Address - Phone:970-422-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-2407-20207RH0002X
CODR.0069497207RH0002X
WAOP60643029208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program