Provider Demographics
NPI:1144238569
Name:CLASSEN, CYNTHIA S (DPM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:S
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:S
Other - Last Name:OBERHOLTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:7505 VILLAGE SQUARE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3692
Mailing Address - Country:US
Mailing Address - Phone:303-805-5156
Mailing Address - Fax:303-805-5157
Practice Address - Street 1:7505 VILLAGE SQUARE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-3692
Practice Address - Country:US
Practice Address - Phone:303-805-5156
Practice Address - Fax:303-805-5157
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO490213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO480033568OtherRRW MEDICARE
COOB51983OtherHMO COLORADO
2700336OtherEVERCARE
COOB51983OtherBCBS
CO84153666401OtherPACIFICARE
CO01004902Medicaid
3893610001OtherPALMETTO
3893610001OtherPALMETTO
CO480033568OtherRRW MEDICARE