Provider Demographics
NPI:1487635173
Name:KELLY, CYNTHIA M (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:M
Last Name:KELLY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-837-0072
Mailing Address - Fax:303-837-0075
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-837-0072
Practice Address - Fax:303-837-0075
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-02-09
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Provider Licenses
StateLicense IDTaxonomies
CO34692207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY115017100Medicaid
NE1245556091Medicaid
NM28887280Medicaid
CO01346923Medicaid
NM28887280Medicaid
COCOA102909Medicare PIN
NE1245556091Medicaid
CO01346923Medicaid