Provider Demographics
NPI:1619039104
Name:THACKER, KAY SCHULTZ (MD)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:SCHULTZ
Last Name:THACKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5921 S MIDDLEFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2858
Mailing Address - Country:US
Mailing Address - Phone:303-798-7215
Mailing Address - Fax:303-973-4777
Practice Address - Street 1:5921 S MIDDLEFIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2858
Practice Address - Country:US
Practice Address - Phone:303-798-7215
Practice Address - Fax:303-973-4777
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO218602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry