Provider Demographics
NPI:1023218880
Name:KLUK, AUGUSTA W (MD)
Entity Type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:W
Last Name:KLUK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:175 S UNION BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3113
Mailing Address - Country:US
Mailing Address - Phone:719-365-1950
Mailing Address - Fax:719-365-1951
Practice Address - Street 1:5818 N NEVADA AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-365-1950
Practice Address - Fax:719-365-1951
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2020-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0056703207X00000X, 207XX0801X, 207XS0106X
TXP8045207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX341859201Medicaid
TX341859201Medicaid