Provider Demographics
NPI:1992389456
Name:PODIATRY ASSOCIATES INC
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-805-5156
Mailing Address - Street 1:7505 VILLAGE SQUARE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3693
Mailing Address - Country:US
Mailing Address - Phone:303-805-5156
Mailing Address - Fax:303-805-5157
Practice Address - Street 1:4500 E 9TH AVE STE 510
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3924
Practice Address - Country:US
Practice Address - Phone:303-805-5156
Practice Address - Fax:303-805-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41272358Medicaid