Cavanaugh, Kenneth J

Cavanaugh, Kenneth J is an individual health care provider with primary practice located at 1551 Professional Ln Suite 200, Longmont CO 80501-6972. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Cavanaugh, Kenneth J can be contacted via phone (303) 772-1600.

Contact Information

Primary practice address
1551 Professional Ln Suite 200 Longmont CO 80501-6972
Fax: (303) 772-9317
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 16429 Colorado

Profile Details

NPI number 1376571638
LBN Legal business name Cavanaugh, Kenneth J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376571638 NPPES
Colorado MEDICAID 01164292
Colorado Other 16429

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