Evergreen Pediatrics, LLC

NPI #1689839144 in Evergreen, Colorado

Provider Information

NPI Number: 1689839144
Entity Type: Organization
Organization Name: Evergreen Pediatrics, LLC
Primary Specialty: Pediatrics
Enumeration Date: Jul 24, 2008
Last Updated: Jul 24, 2008

Practice Location

Address: 30960 STAGECOACH BLVD
Address 2: SUITE W-120
City: Evergreen
State: Colorado
ZIP Code: 80439-7902
Phone: (303) 674-6671

Authorized Official

Name: DR. KENNETH JOHN KUTALEK, M.D.
Title: OWNER
Phone: (303) 674-6671

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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Individual Providers

Provider Name	Specialty	City
DR. Kenneth John Kutalek, MD	Pediatrics	Evergreen	AI Deep Dive
DR. Rudolf Thomas Schmiedt I, MD	Pediatrics	Evergreen	AI Deep Dive
DR. David T Fitzgerald, MD	Pediatrics	Longmont	AI Deep Dive
DR. Wade Heinrichs, MD	Pediatrics	Firestone	AI Deep Dive

Organizations

Provider Name	Specialty	City
Mountain Pediatrics, P.c.	Pediatrics	Evergreen	AI Deep Dive

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