Healthcare Provider Details

I. General information

NPI: 1255314522
Provider Name (Legal Business Name): KIRK A KINDSFATER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702A W DRAKE RD
FORT COLLINS CO
80526-5521
US

IV. Provider business mailing address

702A W DRAKE RD
FORT COLLINS CO
80526-5521
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-0255
  • Fax:
Mailing address:
  • Phone: 970-810-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberDR.0030690
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: