Healthcare Provider Details

I. General information

NPI: 1528756038
Provider Name (Legal Business Name): SEBASTIAN STUDNICKA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 KELLY JOHNSON BLVD STE 310
COLORADO SPRINGS CO
80920-3959
US

IV. Provider business mailing address

1155 KELLY JOHNSON BLVD STE 310
COLORADO SPRINGS CO
80920-3959
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-9800
  • Fax:
Mailing address:
  • Phone: 719-574-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD.0000986
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: