Provider Demographics
NPI:1699842237
Name:GREENWOOD EAR NOSE & THROAT SPECIALISTS PC
Entity Type:Organization
Organization Name:GREENWOOD EAR NOSE & THROAT SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-544-7115
Mailing Address - Street 1:1619 N GREENWOOD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2657
Mailing Address - Country:US
Mailing Address - Phone:719-544-7115
Mailing Address - Fax:719-544-6242
Practice Address - Street 1:1619 N GREENWOOD
Practice Address - Street 2:SUITE 309
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2657
Practice Address - Country:US
Practice Address - Phone:719-544-7115
Practice Address - Fax:719-544-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COGRA3739OtherANTHEM BC BS
CO04005351Medicaid
COB5708Medicare ID - Type Unspecified