Healthcare Provider Details

I. General information

NPI: 1235490822
Provider Name (Legal Business Name): KATHERINE HEUGEL DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 VILLAGE SQUARE DR STE 101
CASTLE PINES CO
80108-3693
US

IV. Provider business mailing address

7505 VILLAGE SQUARE DR STE 101
CASTLE PINES CO
80108-3693
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-5156
  • Fax: 303-805-5157
Mailing address:
  • Phone: 303-805-5156
  • Fax: 303-308-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD.0000912
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: