Healthcare Provider Details

I. General information

NPI: 1255789772
Provider Name (Legal Business Name): KATY MACMURTRIE D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATY MCLAUGHLIN DO

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S CHERRY ST
DENVER CO
80246-1226
US

IV. Provider business mailing address

425 S CHERRY ST
DENVER CO
80246-1226
US

V. Phone/Fax

Practice location:
  • Phone: 720-712-0300
  • Fax: 727-341-4889
Mailing address:
  • Phone: 720-712-0300
  • Fax: 727-341-4865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberV0949
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number011059
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number98821
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0065765
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: