Provider Demographics
NPI:1063824084
Name:MCKITTERICK FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:MCKITTERICK FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERRIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCKITTERICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-327-5143
Mailing Address - Street 1:4185 E WILDCAT RESERVE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-6801
Mailing Address - Country:US
Mailing Address - Phone:303-327-5143
Mailing Address - Fax:303-327-5148
Practice Address - Street 1:4185 E WILDCAT RESERVE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-6801
Practice Address - Country:US
Practice Address - Phone:303-327-5143
Practice Address - Fax:303-327-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-26
Last Update Date:2014-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty