Provider Demographics
NPI:1275524761
Name:LOCHHEAD, KAREN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:LOCHHEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2399 KALMIA AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1964
Mailing Address - Country:US
Mailing Address - Phone:303-998-1050
Mailing Address - Fax:
Practice Address - Street 1:300 EXEMPLA CIR STE 360
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3395
Practice Address - Country:US
Practice Address - Phone:303-327-4700
Practice Address - Fax:303-327-4711
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO39339208M00000X
CO39339207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61333344Medicaid
CO390007414OtherRR MEDICARE
CO019535OtherKAISER COMMERCIAL NUMBER
CO390007414OtherRR MEDICARE
COCO301416Medicare PIN
CO019535OtherKAISER COMMERCIAL NUMBER
C225838Medicare PIN