Provider Demographics
NPI:1760588602
Name:EUGENE M ROSENTHALL, DPM PC
Entity Type:Organization
Organization Name:EUGENE M ROSENTHALL, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ROSENTHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-333-6556
Mailing Address - Street 1:4500 E 9TH AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3900
Mailing Address - Country:US
Mailing Address - Phone:303-333-6556
Mailing Address - Fax:303-333-2593
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3900
Practice Address - Country:US
Practice Address - Phone:303-333-6556
Practice Address - Fax:303-333-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15278379Medicaid
CO5160120001Medicare NSC
COC530298 GROUP #78Medicare ID - Type Unspecified
COU94407Medicare UPIN