Provider Demographics
NPI:1437237799
Name:KITLOWSKI, ROBIN K (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:K
Last Name:KITLOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:L
Other - Last Name:KLACZKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2480 W 26TH AVE
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5309
Mailing Address - Country:US
Mailing Address - Phone:303-467-4155
Mailing Address - Fax:303-467-4156
Practice Address - Street 1:200 EXEMPLA CIR
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3370
Practice Address - Country:US
Practice Address - Phone:303-689-4444
Practice Address - Fax:303-689-4669
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42690208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34483357Medicaid
COC806951Medicare PIN
CO34483357Medicaid