Provider Demographics
NPI:1356388490
Name:HAINGE, FREDERICK WILLIAM (DPM)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:HAINGE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 RESEARCH PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1087
Mailing Address - Country:US
Mailing Address - Phone:719-623-1050
Mailing Address - Fax:719-623-1052
Practice Address - Street 1:2446 RESEARCH PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1087
Practice Address - Country:US
Practice Address - Phone:719-623-1050
Practice Address - Fax:719-623-1052
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00347213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC437178Medicare PIN
COT60329Medicare UPIN
CO01003474Medicaid