Healthcare Provider Details

I. General information

NPI: 1013302181
Provider Name (Legal Business Name): CODY JOSEPH ESTLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2015
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST STE 1183
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

901 W BEN WHITE BLVD
AUSTIN TX
78704-6903
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6999
  • Fax:
Mailing address:
  • Phone: 865-342-8940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberS4299
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberS4299
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberCDR.0004748
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: