MEDICARE: DR. SCOTT E CLEMENS MD

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	207R00000X	Internal Medicine Physician	43463	CO

General Provider Information

NPI Number	:	1649242462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT E CLEMENS MD

Provider Business Mailing Address
First Line	:	12650 W 64TH AVE UNIT E
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-3887
Country	:	US
Telephone Number	:	303-848-3160
Fax Number	:	303-529-3394

Provider Business Practice Location Address
First Line	:	9950 W 80TH AVE
Second Line	:	SUITE 23
City	:	ARVADA
State	:	CO
Zip	:	80005-3927
Country	:	US
Telephone Number	:	303-425-1018
Fax Number	:	303-432-4770

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	12/08/2023

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