MEDICARE: DR. DAVID ERIK OUDERKIRK DPM

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	213E00000X	Podiatrist	585	CO
2	213E00000X	Podiatrist	1200318	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480035364	OTHER	CO	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1659306579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ERIK OUDERKIRK DPM

Provider Business Mailing Address
First Line	:	3464 S WILLOW ST
Second Line	:	STE 138
City	:	DENVER
State	:	CO
Zip	:	80231-4531
Country	:	US
Telephone Number	:	303-755-2900
Fax Number	:	303-755-0404

Provider Business Practice Location Address
First Line	:	2373 CENTRAL PARK BLVD
Second Line	:	STE. #201
City	:	DENVER
State	:	CO
Zip	:	80238-2300
Country	:	US
Telephone Number	:	303-577-0110
Fax Number	:	303-577-0112

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/24/2017

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Directions to “ DR. DAVID ERIK OUDERKIRK DPM” Practice Location

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