Provider Demographics
NPI:1366219990
Name:SCOTT CLEMENS MD PLLC
Entity type:Organization
Organization Name:SCOTT CLEMENS MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-848-3160
Mailing Address - Street 1:12650 W 64TH AVE UNIT E
Mailing Address - Street 2:#150
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3887
Mailing Address - Country:US
Mailing Address - Phone:303-848-3160
Mailing Address - Fax:
Practice Address - Street 1:9035 WADSWORTH PKWY STE 3002
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-8628
Practice Address - Country:US
Practice Address - Phone:303-848-3160
Practice Address - Fax:303-529-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty