Provider Demographics
NPI:1891847612
Name:SCHLEGEL, KARL JAMES (DO)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:JAMES
Last Name:SCHLEGEL
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 1:2111 CHAMPA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2529
Mailing Address - Country:US
Mailing Address - Phone:303-293-2220
Mailing Address - Fax:
Practice Address - Street 1:2130 STOUT STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205
Practice Address - Country:US
Practice Address - Phone:303-312-9518
Practice Address - Fax:303-293-3977
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27741207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01277417Medicaid
CO481728Medicare ID - Type Unspecified
CO01277417Medicaid