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NPI Code Detail

MEDICARE: BRUCE L. KAUTZ M.D.

MEDICARE: BRUCE L. KAUTZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician30304CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083695316
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE L. KAUTZ M.D.
Provider Business Mailing Address
First Line : 2685 DUBLIN BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1358
Country : US
Telephone Number : 719-592-9890
Fax Number : 719-264-7808
Provider Business Practice Location Address
First Line : 2685 DUBLIN BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1358
Country : US
Telephone Number : 719-592-9890
Fax Number : 719-264-6808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 05/29/2008

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Directions to “ BRUCE L. KAUTZ M.D.” Practice Location

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