Individual
DR. KEVIN CLIFFORD CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 DRY CREEK DR, SUITE 103, LONGMONT, CO 80503-7731
(720) 494-9111
(720) 494-9555
Mailing address
1325 DRY CREEK DR, SUITE 103, LONGMONT, CO 80503-7731
(720) 494-9111
(720) 494-9555
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
39322
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94320381
—
CO
Enumeration date
06/28/2005
Last updated
10/26/2015
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