Provider Demographics
NPI:1629334594
Name:ECHOLS, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-0849
Mailing Address - Country:US
Mailing Address - Phone:719-539-4600
Mailing Address - Fax:
Practice Address - Street 1:925 RUSH DR
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9665
Practice Address - Country:US
Practice Address - Phone:719-539-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2020-11-03
Deactivation Date:2018-10-01
Deactivation Code:
Reactivation Date:2018-10-08
Provider Licenses
StateLicense IDTaxonomies
CODR57799207ND0101X, 207ND0900X, 207NS0135X, 207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology