Provider Demographics
NPI:1306322201
Name:SEYBOLD, ERICA (DPM)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SEYBOLD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15901 E BRIARWOOD CIR UNIT 300
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1786
Mailing Address - Country:US
Mailing Address - Phone:303-632-3668
Mailing Address - Fax:303-632-3669
Practice Address - Street 1:15901 E BRIARWOOD CIR UNIT 300
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1786
Practice Address - Country:US
Practice Address - Phone:303-632-3668
Practice Address - Fax:303-632-3669
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA092404213E00000X, 213EP0504X, 213EP1101X, 213ES0103X, 213ES0103X, 213ES0131X
CO879213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery