Provider Demographics
NPI:1972784502
Name:DILLARD, CLINT T (PA)
Entity Type:Individual
Prefix:MR
First Name:CLINT
Middle Name:T
Last Name:DILLARD
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Gender:M
Credentials:PA
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Mailing Address - Street 1:3033 S PARKER RD
Mailing Address - Street 2:STE 800
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2910
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:3033 S PARKER RD
Practice Address - Street 2:STE 800
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2910
Practice Address - Country:US
Practice Address - Phone:303-306-7783
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2020-06-01
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Provider Licenses
StateLicense IDTaxonomies
CO2506363A00000X
COPA.0002506363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant