Healthcare Provider Details

I. General information

NPI: 1801846514
Provider Name (Legal Business Name): BRET A KORT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6285 LEHMAN DR SUITE 200
COLORADO SPRINGS CO
80918-1499
US

IV. Provider business mailing address

6285 LEHMAN DR SUITE 200
COLORADO SPRINGS CO
80918-1499
US

V. Phone/Fax

Practice location:
  • Phone: 719-260-7050
  • Fax: 719-260-9757
Mailing address:
  • Phone: 719-260-7050
  • Fax: 719-260-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number33462
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: