ENT CLINIC OF PUEBLO PROF LLC – Otolaryngology Physician, NPI 1376595504

ENT CLINIC OF PUEBLO PROF LLC is a healthcare provider. based in Pueblo, Colorado. specializing in Otolaryngology Physician. The NPI Number for ENT CLINIC OF PUEBLO PROF LLC is 1376595504

Main info

Organization
Name
ENT CLINIC OF PUEBLO PROF LLC
NPI
1376595504
Phone
(719) 544-3752
Address
1304 N GRAND AVE
Authorized Official
DR. CHARLENE J HICKSON OWNER/PARTNER M.D.
Enumeration Date
16 May 2006
Last Update Date
30 January 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for ENT CLINIC OF PUEBLO PROF LLC

  • 1304, North Grand Avenue, Mineral Palace, Pueblo, Pueblo County, Colorado, 81003, United States

    PUEBLO, CO 810032759

    Phone: (719) 544-3752

    Fax: (719) 542-1794

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81003)

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Reviews

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Frequently asked questions

Is ENT CLINIC OF PUEBLO PROF LLC listed with a National Provider Identifier?
Yes — ENT CLINIC OF PUEBLO PROF LLC has NPI 1376595504 on file in the registry.
Active or inactive — what applies to ENT CLINIC OF PUEBLO PROF LLC?
You should see ENT CLINIC OF PUEBLO PROF LLC as active in CMS-hosted NPPES data.
How would a patient describe ENT CLINIC OF PUEBLO PROF LLC's focus?
For ENT CLINIC OF PUEBLO PROF LLC, the primary taxonomy reads as Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ENT CLINIC OF PUEBLO PROF LLC?
Travel planning: use Pueblo, Colorado as the reference point for ENT CLINIC OF PUEBLO PROF LLC, then confirm.
Does ENT CLINIC OF PUEBLO PROF LLC accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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