Provider Demographics
NPI:1356330617
Name:BRINKMAN, JUDITH M
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:M
Other - Last Name:BRINKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 780453
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0453
Mailing Address - Country:US
Mailing Address - Phone:303-306-7778
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:6001 E WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-776-5000
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38560207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44051221Medicaid
CO44051221Medicaid
COX7968Medicare ID - Type Unspecified