Individual
KEVIN J CHISMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E. PAVILION PLACE, SUITE B, MONTROSE, CO 81401
(970) 249-1210
(970) 249-3057
Mailing address
1800 E. PAVILION PLACE, SUITE B, MONTROSE, CO 81401
(970) 249-1210
(970) 249-3057
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27759
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54774845
—
CO
01
—
667552
BLUECROSS BLUESHIELD
—
01
—
840851676006
ROCKY MOUNTAIN HEALTH PLA
—
01
—
P00094915
RAILROAD MEDICARE
—
Enumeration date
01/18/2007
Last updated
10/30/2007
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