Provider Demographics
NPI:1740462498
Name:PAUL T. VOEGELI, JR
Entity type:Organization
Organization Name:PAUL T. VOEGELI, JR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:VOEGELI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-980-1166
Mailing Address - Street 1:165 S UNION BLVD
Mailing Address - Street 2:SUITE 322
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2215
Mailing Address - Country:US
Mailing Address - Phone:303-980-1166
Mailing Address - Fax:303-988-3995
Practice Address - Street 1:165 S UNION BLVD
Practice Address - Street 2:SUITE 322
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2215
Practice Address - Country:US
Practice Address - Phone:303-980-1166
Practice Address - Fax:303-988-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00381213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01003813Medicaid
CO0455300001Medicare NSC
CO01003813Medicaid
COC56333Medicare PIN