Provider Demographics
NPI:1326249269
Name:MURRAY, KATHRYN K (DO)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:K
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2773 JANITELL RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4102
Mailing Address - Country:US
Mailing Address - Phone:719-365-6478
Mailing Address - Fax:719-365-7981
Practice Address - Street 1:6011 E WOODMEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2602
Practice Address - Country:US
Practice Address - Phone:719-571-8100
Practice Address - Fax:719-571-8110
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01225051Medicaid
CO95573577Medicaid
CO87588820Medicaid
CO87588820Medicaid
CO95573577Medicaid