Provider Demographics
NPI:1760448690
Name:CATHCART, CYNTHIA KARNES (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KARNES
Last Name:CATHCART
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 1:1 MERCADO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7306
Mailing Address - Country:US
Mailing Address - Phone:970-385-7977
Mailing Address - Fax:970-385-6727
Practice Address - Street 1:1 MERCADO ST STE 100
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7306
Practice Address - Country:US
Practice Address - Phone:970-385-7977
Practice Address - Fax:970-385-6727
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42965207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18386831Medicaid
CO841272258007OtherRMHP
NMZ4525Medicaid
COC452278OtherOFFICE MEDICARE
COCAC35919OtherBLUE CROSS BLUE SHIELD
P00324667OtherRAILROAD MEDICARE
NMNM001P09OtherBLUE CROSS BLUE SHIELD
UTT0296Medicaid
AZ635279Medicaid
AZ635279Medicaid
COC14310Medicare UPIN
NMNM001P09OtherBLUE CROSS BLUE SHIELD