Kyra Hootman Do Pc | |
2001 Lake Ave Pueblo CO 81004-3538 | |
(719) 564-0300 | |
(719) 564-0303 |
Full Name | Kyra Hootman Do Pc |
---|---|
Speciality | Internal Medicine |
Location | 2001 Lake Ave, Pueblo, Colorado |
Authorized Official Name and Position | Carole J Walls (OFFICE MANAGER) |
Authorized Official Contact | 7195640300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kyra Hootman Do Pc 2001 Lake Ave Pueblo CO 81004-3538 Ph: (719) 564-0300 | Kyra Hootman Do Pc 2001 Lake Ave Pueblo CO 81004-3538 Ph: (719) 564-0300 |
NPI Number | 1558528919 |
---|---|
Provider Enumeration Date | 05/21/2008 |
Last Update Date | 10/29/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558528919 | NPI | - | NPPES |
89623827 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 38729 (Colorado) | Primary |
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