Provider Demographics
NPI:1639101835
Name:COLORADO SPRINGS PATHOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:COLORADO SPRINGS PATHOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-368-7247
Mailing Address - Street 1:2838 JANITELL RD., E
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4141
Mailing Address - Country:US
Mailing Address - Phone:719-368-7247
Mailing Address - Fax:719-359-5500
Practice Address - Street 1:2838 JANITELL RD., E
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4141
Practice Address - Country:US
Practice Address - Phone:719-368-7247
Practice Address - Fax:719-359-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94485771Medicaid
CODF3469Medicare PIN
CO806239Medicare PIN