MEDICARE: DR. KENNETH SCOTT KIME D.O.

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	207Q00000X	Family Medicine Physician	34451	CO

General Provider Information

NPI Number	:	1629058367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH SCOTT KIME D.O.

Provider Business Mailing Address
First Line	:	USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Second Line	:	1650 COCHRANE CIRCLE, ATTN: CREDENTIALS OFFICE
City	:	FT. CARSON
State	:	CO
Zip	:	80913-4604
Country	:	US
Telephone Number	:	719-526-7844
Fax Number	:	719-526-7984

Provider Business Practice Location Address
First Line	:	USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Second Line	:	1650 COCHRANE CIRCLE, ATTN: EMERGENCY DEPT
City	:	FT. CARSON
State	:	CO
Zip	:	80913-4604
Country	:	US
Telephone Number	:	719-526-7650
Fax Number	:	719-524-4090

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	08/10/2025

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