Provider Demographics
NPI:1902180763
Name:STEELE, KEVIN (SA-C)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3174
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80161-3174
Mailing Address - Country:US
Mailing Address - Phone:303-425-7538
Mailing Address - Fax:720-316-7999
Practice Address - Street 1:1720 SHEA CENTER DR
Practice Address - Street 2:#106
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-3528
Practice Address - Country:US
Practice Address - Phone:303-425-7538
Practice Address - Fax:720-316-7999
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA-C 11-168OtherAMERICAN BOARD OF SURGICAL ASSISTANTS
SA-C-168OtherSURGICAL ASSISTANT - CERTIFIED
TXSA00460OtherLSA