Healthcare Provider Details

I. General information

NPI: 1386384808
Provider Name (Legal Business Name): KYLE REED BARKDULL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CHICO CT
MONTE VISTA CO
81144-1065
US

IV. Provider business mailing address

3160 XANADU ST
AURORA CO
80011-2031
US

V. Phone/Fax

Practice location:
  • Phone: 719-852-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0073709
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: