Provider Demographics
NPI:1134487168
Name:KEHOE, MICHAEL PATRICK (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:KEHOE
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Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2460 WEST 26TH AVE
Mailing Address - Street 2:SUITE 420-C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211
Mailing Address - Country:US
Mailing Address - Phone:303-444-8337
Mailing Address - Fax:303-444-8393
Practice Address - Street 1:275 CENTURY CIRCLE
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:303-444-8337
Practice Address - Fax:303-444-8393
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2018-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106334363AM0700X
COPA0005002363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical