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General NPI Number Information
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NPI Number | 1396560017
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE CENTER OF COLORADO SPRINGS
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 6160 TUTT BLVD STE 250
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-1500
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Country | US
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Telephone | 719-559-3388
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Fax | 719-559-3509
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Provider Business Mailing Address
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Address Line | 1266 ESCALANTE DR
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City | DURANGO
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State | CO
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Zip | 81303-8933
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Country | US
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Telephone | 719-559-3388
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Fax | 719-559-3509
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Authorized Official
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Title or Position | OWNER
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Name | KAYSE L LAKE
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Credential | DPM
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Telephone | 719-559-3388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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