Provider Demographics
NPI:1104861947
Name:MEKEEL, KRISTIN L (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:L
Last Name:MEKEEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:LEIGH
Other - Last Name:MEKEEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35672204F00000X
CAC54096204F00000X
FLME90794208600000X
CODR.0074919204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270663600Medicaid
AZ115142Medicaid
AZ860800150 85054 D001OtherTRICARE
AZP00625149OtherRAILROAD MEDICARE
FL48025Medicare ID - Type Unspecified
AZ115142Medicaid
FL270663600Medicaid