Provider Demographics
NPI:1437152550
Name:NAFTULIN, KEITH A (DPM)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:NAFTULIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 S BALSAM WAY
Mailing Address - Street 2:STE 290
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3087
Mailing Address - Country:US
Mailing Address - Phone:303-932-7957
Mailing Address - Fax:303-933-8271
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:STE 290
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3087
Practice Address - Country:US
Practice Address - Phone:303-932-7957
Practice Address - Fax:303-933-8271
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO472213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01004720Medicaid
COU46785Medicare UPIN
COCOA109818Medicare PIN
COC55023Medicare PIN
CO01004720Medicaid
COCOA109819Medicare PIN