Provider Demographics
NPI:1962485599
Name:AIKIN, KENT R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:R
Last Name:AIKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N MILDRED RD
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-2231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1311 N MILDRED RD
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-2231
Practice Address - Country:US
Practice Address - Phone:970-564-2104
Practice Address - Fax:970-564-2134
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21642208M00000X
VA0101-053016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010029074Medicaid
VA5624908Medicaid
002910C40Medicare PIN
VA002910C40Medicare ID - Type Unspecified
VA5624908Medicaid
VA017954C18Medicare PIN
VAD23966Medicare UPIN