Provider Demographics
NPI:1760683841
Name:RED ROCKS FOOT & ANKLE CENTER PLLC
Entity Type:Organization
Organization Name:RED ROCKS FOOT & ANKLE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-797-6001
Mailing Address - Street 1:11 W DRY CREEK CIR
Mailing Address - Street 2:#110
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8078
Mailing Address - Country:US
Mailing Address - Phone:303-797-6001
Mailing Address - Fax:303-797-7452
Practice Address - Street 1:11 W DRY CREEK CIR
Practice Address - Street 2:#110
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8078
Practice Address - Country:US
Practice Address - Phone:303-797-6001
Practice Address - Fax:303-797-7452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO623213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC808250Medicare UPIN