Provider Demographics
NPI:1336121623
Name:HOWARD, CLANCY S (MD)
Entity Type:Individual
Prefix:DR
First Name:CLANCY
Middle Name:S
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:130 RAMPART WAY
Mailing Address - Street 2:300-B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6440
Mailing Address - Country:US
Mailing Address - Phone:303-327-4700
Mailing Address - Fax:303-327-4711
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:STE 4300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-327-4700
Practice Address - Fax:303-327-4711
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO40607207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89122356Medicaid
COI29017Medicare UPIN
CO801767Medicare ID - Type Unspecified