Denver Occupational & Aviation Med. Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16150 Issued in CO

Legal business name

DENVER OCCUPATIONAL & AVIATION MED. CLINIC

Practice address

3700 Havana St
Suite 200
Denver, CO 80239-3240

Phone

(303) 373-4456

Fax

(303) 373-4501

NPI assigned

Sep 9, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clarence J. Kluck, M.D.

Title

Owner

Phone

(303) 373-4456

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003800558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 S WILLOW ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802314531",
            "telephone_number": "303-755-2900",
            "fax_number": "303-755-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 HAVANA ST",
            "address_2": "SUITE 200",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802393240",
            "telephone_number": "303-373-4456",
            "fax_number": "303-373-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENVER OCCUPATIONAL & AVIATION MED. CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLUCK",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-373-4456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "16150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C49821",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "KW63304",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Denver, CO
• Providers in Denver, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.