Provider Demographics
NPI:1275689598
Name:PARSONS, KENNETH CLINTON (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CLINTON
Last Name:PARSONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6367 S JAMAICA CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6628
Mailing Address - Country:US
Mailing Address - Phone:720-379-7163
Mailing Address - Fax:303-953-8562
Practice Address - Street 1:6367 S JAMAICA CT
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6628
Practice Address - Country:US
Practice Address - Phone:720-379-7163
Practice Address - Fax:303-953-8562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO249802081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA93544Medicare UPIN