Healthcare Provider Details

I. General information

NPI: 1366683088
Provider Name (Legal Business Name): KEITH A NAFTULIN, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 06/13/2020
Certification Date: 06/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6169 S BALSAM WAY 270
LITTLETON CO
80123-3062
US

IV. Provider business mailing address

6169 S BALSAM WAY STE 290
LITTLETON CO
80123-3064
US

V. Phone/Fax

Practice location:
  • Phone: 303-932-7957
  • Fax: 303-933-8271
Mailing address:
  • Phone: 303-932-7957
  • Fax: 303-933-8271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number472
License Number StateCO

VIII. Authorized Official

Name: DR. KEITH A NAFTULIN
Title or Position: PRESIDENT
Credential: DPM
Phone: 303-932-7957