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General NPI Number Information
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NPI Number | 1336152719
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Entity Type | Individual
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Provider Name | JOHN KEVIN STANTON D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 1950 REDTAIL HAWK DR
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City | ESTES PARK
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State | CO
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Zip | 80517-9780
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Country | US
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Telephone | 970-586-9230
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Fax | 970-586-0292
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Provider Business Mailing Address
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Address Line | 203 S ROLLIE AVE
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City | FORT LUPTON
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State | CO
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Zip | 80621-1508
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Country | US
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Telephone | 303-286-4560
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Fax | 303-286-4589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0029086
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License Number State | CO
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