Provider Demographics
NPI:1083033211
Name:PODIATRY ASSOCIATES INC
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES INC
Other - Org Name:PARKER FOOT AND ANKLE CLINIC, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-805-5156
Mailing Address - Street 1:7505 VILLAGE SQUARE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3693
Mailing Address - Country:US
Mailing Address - Phone:303-805-5156
Mailing Address - Fax:303-805-5157
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8575
Practice Address - Country:US
Practice Address - Phone:303-805-5156
Practice Address - Fax:303-805-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPOD.0000490213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO3893610001Medicare NSC