Provider Demographics
NPI:1659306579
Name:OUDERKIRK, DAVID ERIK (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ERIK
Last Name:OUDERKIRK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:STE 138
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-755-0404
Practice Address - Street 1:2373 CENTRAL PARK BLVD
Practice Address - Street 2:STE. #201
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2300
Practice Address - Country:US
Practice Address - Phone:303-577-0110
Practice Address - Fax:303-577-0112
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO585213E00000X
KS1200318213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29473373Medicaid
CO480035364OtherRAILROAD MEDICARE
U81580Medicare UPIN
COC476988Medicare PIN