Provider Demographics
NPI:1568507242
Name:OATIS, WENDY S (MD)
Entity Type:Individual
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First Name:WENDY
Middle Name:S
Last Name:OATIS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:550 W US HIGHWAY 50
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2238
Mailing Address - Country:US
Mailing Address - Phone:719-530-2048
Mailing Address - Fax:719-530-2055
Practice Address - Street 1:525 N FOOTE AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-4561
Practice Address - Country:US
Practice Address - Phone:719-365-6568
Practice Address - Fax:719-365-6317
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-01-28
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Provider Licenses
StateLicense IDTaxonomies
CODR-49157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83103554Medicaid
COCOA109681Medicare PIN
COCOA103933Medicare PIN