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General NPI Number Information
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NPI Number | 1679266118
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Entity Type | Individual
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Provider Name | CODEE CLARK SPIERS PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 13402 W COAL MINE AVE STE 110
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City | LITTLETON
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State | CO
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Zip | 80127-5408
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Country | US
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Telephone | 303-248-7894
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Fax |
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Provider Business Mailing Address
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Address Line | 6556 EMERALD DUNES DR APT 208
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-2752
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Country | US
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Telephone |
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Fax |
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | PA9117321
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0008902
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License Number State | CO
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