Provider Demographics
NPI:1134424963
Name:MEDDLES, KATHARINE (MD)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:MEDDLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5507
Mailing Address - Country:US
Mailing Address - Phone:303-226-7230
Mailing Address - Fax:866-401-9731
Practice Address - Street 1:2055 N HIGH ST STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5507
Practice Address - Country:US
Practice Address - Phone:303-226-7230
Practice Address - Fax:866-401-9731
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115350208000000X, 2084N0402X
CO00615372084N0402X
MO20120217502084N0402X, 282N00000X, 282NC2000X
CODR.00615372084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No282N00000XHospitalsGeneral Acute Care Hospital
No282NC2000XHospitalsGeneral Acute Care HospitalChildren