Provider Demographics
NPI:1649298746
Name:KELTS, ELIZABETH ANNE STONE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE STONE
Last Name:KELTS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:12081 W ALAMEDA PKWY # 438
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2701
Mailing Address - Country:US
Mailing Address - Phone:303-551-3643
Mailing Address - Fax:720-328-9653
Practice Address - Street 1:12081 W ALAMEDA PKWY # 438
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2701
Practice Address - Country:US
Practice Address - Phone:303-551-3643
Practice Address - Fax:720-328-9653
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO43943207Q00000X
CODR.OO43943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08039356Medicaid
CO419294Other419294
CO804509Medicare ID - Type Unspecified