Provider Demographics
NPI:1346411410
Name:ERIK W. KREUTZER, M.D., P.C., DBA COLORADO EAR, NOSE & THROAT GROUP
Entity Type:Organization
Organization Name:ERIK W. KREUTZER, M.D., P.C., DBA COLORADO EAR, NOSE & THROAT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KREUTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-238-1366
Mailing Address - Street 1:255 UNION BLVD
Mailing Address - Street 2:SUITE # 220
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1810
Mailing Address - Country:US
Mailing Address - Phone:303-238-1366
Mailing Address - Fax:303-238-0038
Practice Address - Street 1:255 UNION BLVD
Practice Address - Street 2:SUITE # 220
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1810
Practice Address - Country:US
Practice Address - Phone:303-238-1366
Practice Address - Fax:303-238-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04012019Medicaid
COCD8808Medicare PIN