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General NPI Number Information
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NPI Number | 1043521065
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Entity Type | Individual
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Provider Name | CHRISTODOULOS KAOUTZANIS MD BSC
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 1635 AURORA CT
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City | AURORA
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State | CO
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Zip | 80045-2541
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Country | US
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Telephone | 720-848-0800
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Fax |
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Provider Business Mailing Address
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Address Line | ACADEMIC OFFICE 1 (AO1) 12631 E. 17TH AVE, C309
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City | AURORA
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State | CO
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Zip | 80045
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Country | US
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Telephone | 734-834-0597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | DR.0062812
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | DR.0062812
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License Number State | CO
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