Provider Demographics
NPI:1629058367
Name:KIME, KENNETH SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:SCOTT
Last Name:KIME
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:1650 COCHRANE CIRCLE, ATTN: CREDENTIALS OFFICE
Mailing Address - City:FT. CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-7844
Mailing Address - Fax:719-526-7984
Practice Address - Street 1:USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:1650 COCHRANE CIRCLE, ATTN: EMERGENCY DEPT
Practice Address - City:FT. CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-526-7650
Practice Address - Fax:719-524-4090
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-03-04
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO34451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine