Healthcare Provider Details

I. General information

NPI: 1346423514
Provider Name (Legal Business Name): DOUGLAS H. KIRKPATRICK,MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 KIPLING ST SUITE 107
LAKEWOOD CO
80215-2873
US

IV. Provider business mailing address

48 HYDE PARK CIR
DENVER CO
80209-3551
US

V. Phone/Fax

Practice location:
  • Phone: 303-762-9050
  • Fax: 303-762-9141
Mailing address:
  • Phone: 303-762-9050
  • Fax: 303-762-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number19432
License Number StateCO

VIII. Authorized Official

Name: DOUGLAS HAIGH KIRKPATRICK
Title or Position: PRESIDENT
Credential: MD
Phone: 303-762-9050