Provider Demographics
NPI:1053597849
Name:KIMBERLY C STONE MD PC
Entity type:Organization
Organization Name:KIMBERLY C STONE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-806-8600
Mailing Address - Street 1:3701 S CLARKSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3958
Mailing Address - Country:US
Mailing Address - Phone:303-806-8600
Mailing Address - Fax:303-866-8629
Practice Address - Street 1:3701 S CLARKSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3958
Practice Address - Country:US
Practice Address - Phone:303-806-8600
Practice Address - Fax:303-866-8629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38869207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG49641Medicare UPIN