Provider Demographics
NPI:1245202506
Name:KENEY, LOCKE P (MD)
Entity Type:Individual
Prefix:
First Name:LOCKE
Middle Name:P
Last Name:KENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE 660
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-649-3200
Mailing Address - Fax:303-765-6201
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE 660
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-649-3200
Practice Address - Fax:303-765-6201
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05358329Medicaid
CO802376Medicare PIN
CO05358329Medicaid