Individual
DR. RICHARD SEAWELL CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1375 E 20TH AVE, DENVER, CO 80205-5422
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
49694
MN
2084N0400X
Neurology Physician
Primary
50255
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021650000
—
MN
01
—
028964
KAISER COMMERCIAL NUMBER
CO
05
—
9000124605
—
CO
01
—
COA107357
MEDICARE PTAN
CO
Enumeration date
04/24/2007
Last updated
04/28/2021
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