Healthcare Provider Details

I. General information

NPI: 1578993762
Provider Name (Legal Business Name): COLORADO PODIATRY CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2352 MEADOWS BLVD STE 300
CASTLE ROCK CO
80109-8419
US

IV. Provider business mailing address

2727 BRYANT ST STE 400
DENVER CO
80211-4170
US

V. Phone/Fax

Practice location:
  • Phone: 720-855-9214
  • Fax: 720-855-9291
Mailing address:
  • Phone: 720-855-9214
  • Fax: 720-855-9291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ZYZDA
Title or Position: PRESIDENT
Credential:
Phone: 720-855-9214