Provider Demographics
NPI:1346458510
Name:VOIGTS, KERRI RENEE (MD)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:RENEE
Last Name:VOIGTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:RENEE
Other - Last Name:SISTRUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:95 S PAGOSA BLVD
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-8329
Mailing Address - Country:US
Mailing Address - Phone:970-731-3700
Mailing Address - Fax:
Practice Address - Street 1:95 S PAGOSA BLVD
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-8329
Practice Address - Country:US
Practice Address - Phone:970-731-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0466207P00000X
IL125-051129207P00000X
CODR.0060185207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202077801Medicaid
TX202077802Medicaid
TXP00802568OtherRAILROAD
ILP00726915OtherRAILROAD MCARE
IL210426003Medicare PIN
TX202077801Medicaid