Healthcare Provider Details

I. General information

NPI: 1285671420
Provider Name (Legal Business Name): DIRK P PIKAART DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 10/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BOB PETERS GRV STE 309
COLORADO SPRINGS CO
80909-4533
US

IV. Provider business mailing address

PO BOX 911057
DENVER CO
80291-1057
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6464
  • Fax:
Mailing address:
  • Phone: 303-643-1099
  • Fax: 303-643-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberOS9614
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberDR.0046622
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: