Provider Demographics
NPI:1154386795
Name:KEMLING, GUY L (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:L
Last Name:KEMLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 N GREENWOOD ST STE 208
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2656
Mailing Address - Country:US
Mailing Address - Phone:719-561-4336
Mailing Address - Fax:719-561-8469
Practice Address - Street 1:1619 N GREENWOOD ST STE 208
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2656
Practice Address - Country:US
Practice Address - Phone:719-561-4336
Practice Address - Fax:719-561-8469
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31270207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F44009Medicare UPIN