Healthcare Provider Details

I. General information

NPI: 1093858607
Provider Name (Legal Business Name): KAYSIE LYNN BANTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE STE 200
ENGLEWOOD CO
80113-2788
US

IV. Provider business mailing address

601 E HAMPDEN AVE STE 200
ENGLEWOOD CO
80113-2788
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-5300
  • Fax: 303-788-5363
Mailing address:
  • Phone: 303-788-5300
  • Fax: 303-788-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0059860
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberDR.0059860
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: