1265443311 NPI number — KATHERINE L. NORTON M.S.O.T.

Table of content: THALIA M RODRIGUEZ (NPI 1497476709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265443311 NPI number — KATHERINE L. NORTON M.S.O.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORTON
Provider First Name:
KATHERINE
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.O.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265443311
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6979 S HOLLY CIR
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-1577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-694-2295
Provider Business Mailing Address Fax Number:
303-694-1843

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 GOLDEN RIDGE RD
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
GOLDEN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80401-9541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-275-2190
Provider Business Practice Location Address Fax Number:
303-275-2191
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  1075081 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102255322 . This is a "OWCP FACITITY ID" identifier . This identifiers is of the category "OTHER".




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