Provider Demographics
NPI:1699858225
Name:HOEKSTRA, KATHERINE E (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:HOEKSTRA
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 1:527 HOLMAN WAY
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:527 HOLMAN WAY
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5252
Practice Address - Country:US
Practice Address - Phone:303-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO348308OtherMEDICARE GROUP NUMBER
CO74305263OtherMEDICAID GROUP NUMBER
COC810776OtherMEDICARE GROUP NUMBER
CODN2433OtherRR MEDICARE GROUP
CO42725232Medicaid
CODN2433OtherRR MEDICARE GROUP
COCO40974Medicare PIN
COP00624688Medicare PIN
COC811079Medicare PIN
COCO303840Medicare PIN
CO810478Medicare PIN