Healthcare Provider Details

I. General information

NPI: 1508863382
Provider Name (Legal Business Name): CURTIS L HAGEDORN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 FRANKLIN ST SUITE 180
DENVER CO
80205-5401
US

IV. Provider business mailing address

2005 FRANKLIN ST SUITE 180
DENVER CO
80205-5401
US

V. Phone/Fax

Practice location:
  • Phone: 303-831-7419
  • Fax: 303-831-7423
Mailing address:
  • Phone: 303-831-7419
  • Fax: 303-831-7423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number43556
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: