Provider Demographics
NPI:1578792388
Name:GOLDHAIR, KATIE WILLIAMS (MD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:WILLIAMS
Last Name:GOLDHAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:RENEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3900 E MEXICO AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3940
Mailing Address - Country:US
Mailing Address - Phone:720-524-1001
Mailing Address - Fax:303-756-0898
Practice Address - Street 1:400 INDIANA ST STE 360
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:720-524-1001
Practice Address - Fax:303-756-0898
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206023207W00000X
MSAU5009697-1599207W00000X
CODR.0055722207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2336975Medicaid
MS08238039Medicaid
LA294813YH3UMedicare PIN