MEDICARE: DR. DALE CORDELL KISTLER 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
1	207L00000X	Anesthesiology Physician	16904	CO

General Provider Information

NPI Number	:	1093070518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE CORDELL KISTLER M.D.

Provider Business Mailing Address
First Line	:	2225 S DAYTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3426
Country	:	US
Telephone Number	:	303-751-5435
Fax Number	:	650-471-6371

Provider Business Practice Location Address
First Line	:	2225 S DAYTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3426
Country	:	US
Telephone Number	:	303-751-5435
Fax Number	:	650-471-6371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2012
Last Update Date	:	02/15/2026

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