Provider Demographics
NPI:1801845615
Name:KAHLER, DURAND JAE (DO)
Entity Type:Individual
Prefix:DR
First Name:DURAND
Middle Name:JAE
Last Name:KAHLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3616
Mailing Address - Country:US
Mailing Address - Phone:970-522-7100
Mailing Address - Fax:970-522-7106
Practice Address - Street 1:118 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3616
Practice Address - Country:US
Practice Address - Phone:970-522-7100
Practice Address - Fax:970-522-7106
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01217397Medicaid
COC5902Medicare ID - Type Unspecified
CO01217397Medicaid