Provider Demographics
NPI:1215090915
Name:CATRON, ANDREW CLARK (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CLARK
Last Name:CATRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16172 HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-8959
Mailing Address - Country:US
Mailing Address - Phone:970-423-8850
Mailing Address - Fax:970-423-8850
Practice Address - Street 1:16172 US HWY 9
Practice Address - Street 2:SWAN MOUNTAIN WOMENS CENTER
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424
Practice Address - Country:US
Practice Address - Phone:970-423-8840
Practice Address - Fax:970-423-8850
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32699207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01326990Medicaid
CO01326990Medicaid
COF8128Medicare ID - Type Unspecified