Healthcare Provider Details

I. General information

NPI: 1013563071
Provider Name (Legal Business Name): KELLY A VOGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE FL 3
AURORA CO
80045-2545
US

IV. Provider business mailing address

12605 E 16TH AVE FL 3
AURORA CO
80045-2545
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-5300
  • Fax: 615-583-7961
Mailing address:
  • Phone: 720-848-5300
  • Fax: 615-583-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: