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ENT CLINIC OF PUEBLO PROF LLC
NPI 1376595504
Otolaryngology in Pueblo, CO

Active since May 16, 2006
1304 N GRAND AVE, PUEBLO, CO 81003(719) 544-3752(719) 542-1794 Get Directions Write a Review

NPPES record last updated: January 30, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ent Clinic Of Pueblo Prof Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENT CLINIC OF PUEBLO PROF LLC (NPI 1376595504) is a healthcare organization registered as an otolaryngology in Pueblo, Colorado and active in the NPI registry since May 2006. The organization lists Charlene J Hickson, Owner/partner, as its authorized official.

NPPES Registry Identity

NPI1376595504
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameENT CLINIC OF PUEBLO PROF LLC
Location Address1304 N GRAND AVEPueblo, CO 81003-2759
Mailing Address1304 N Grand AvePueblo, CO 81003-2759 · (719) 544-3752 · Fax (719) 542-1794
Phone(719) 544-3752
Fax(719) 542-1794
Organization SubpartNo
Authorized OfficialCharlene J HicksonOwner/partner · (719) 544-3752
Enumeration DateMay 16, 2006
Last NPPES UpdateJanuary 30, 2008
✔ NPI 1376595504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1304 N GRAND AVE, Pueblo, CO 81003
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Other Identifiers 2

Medicare ID-Type Unspecified502258CO
Medicaid78674247CO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHILIP CHARLES MARIN MD
Plastic Surgery
1304 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 669-8487
SHAILEEN JOHNSON FNP-C
Nurse Practitioner
1304 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 562-2360
ENT CLINIC OF PUEBLO, P.C.
Otolaryngology
1304 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 544-3752
DR. JULIE A NEWBURG M.D.
Otolaryngology
1304 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 544-3752

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ent Clinic Of Pueblo Prof LLC's NPI number?

The NPI number for Ent Clinic Of Pueblo Prof LLC is 1376595504. It was assigned to this organization in the NPPES registry on May 16, 2006.

Where is Ent Clinic Of Pueblo Prof LLC located?

Ent Clinic Of Pueblo Prof LLC is located at 1304 N Grand Ave, Pueblo, CO 81003. The listed phone number is (719) 544-3752.

What is Ent Clinic Of Pueblo Prof LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

When was this NPI record last updated?

The NPPES record for Ent Clinic Of Pueblo Prof LLC was last updated on January 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.