MEDICARE: KEVIN M ALLEN PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1649	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508841545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M ALLEN PAC

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:	719-365-1950
Fax Number	:	719-365-1951

Provider Business Practice Location Address
First Line	:	175 S UNION BLVD STE 125
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3117
Country	:	US
Telephone Number	:	719-365-1950
Fax Number	:	719-365-1951

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/22/2025

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Directions to “ KEVIN M ALLEN PAC” Practice Location

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