Provider Demographics
NPI:1578781555
Name:COWPERTHWAITE, KEVIN EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:EARL
Last Name:COWPERTHWAITE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1720 S BELLAIRE ST
Mailing Address - Street 2:SUITE 900
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4304
Mailing Address - Country:US
Mailing Address - Phone:303-758-0217
Mailing Address - Fax:303-758-0218
Practice Address - Street 1:1720 S BELLAIRE ST
Practice Address - Street 2:SUITE 900
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4304
Practice Address - Country:US
Practice Address - Phone:303-758-0217
Practice Address - Fax:303-758-0218
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2013-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO334232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01334234Medicaid
CO284948YQKBMedicare PIN