Healthcare Provider Details

I. General information

NPI: 1699842237
Provider Name (Legal Business Name): GREENWOOD EAR NOSE & THROAT SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 N GREENWOOD SUITE 309
PUEBLO CO
81003-2657
US

IV. Provider business mailing address

1619 N GREENWOOD SUITE 309
PUEBLO CO
81003-2657
US

V. Phone/Fax

Practice location:
  • Phone: 719-544-7115
  • Fax: 719-544-6242
Mailing address:
  • Phone: 719-544-7115
  • Fax: 719-544-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CLIFFORD SCOTT HOWE
Title or Position: PRESIDENT
Credential: MD
Phone: 719-544-7115