Provider Demographics
NPI:1215011689
Name:RILEY, JULIA K (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:K
Last Name:RILEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 S CASCADE AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1604
Mailing Address - Country:US
Mailing Address - Phone:719-400-7472
Mailing Address - Fax:719-538-2990
Practice Address - Street 1:1536 COLE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3426
Practice Address - Country:US
Practice Address - Phone:303-763-4900
Practice Address - Fax:303-763-5495
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001061A213ES0103X
COPOD.0000847213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200911420Medicaid
151560C6Medicare PIN