Provider Demographics
NPI:1740867316
Name:KOLODZIEJCZYK, TESIA (DO)
Entity type:Individual
Prefix:DR
First Name:TESIA
Middle Name:
Last Name:KOLODZIEJCZYK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15070 E COACHMAN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2204
Mailing Address - Country:US
Mailing Address - Phone:719-231-4025
Mailing Address - Fax:
Practice Address - Street 1:8089 S LINCOLN ST STE 300
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2721
Practice Address - Country:US
Practice Address - Phone:720-851-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0074615207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program