Provider Demographics
NPI:1558351049
Name:KULWICKI, KEVIN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:KULWICKI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:10535 PARK MEADOWS BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8456
Mailing Address - Country:US
Mailing Address - Phone:303-662-8250
Mailing Address - Fax:303-662-8249
Practice Address - Street 1:4780 N JOSEY LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4615
Practice Address - Country:US
Practice Address - Phone:972-492-1334
Practice Address - Fax:972-492-5174
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2025-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI39357207X00000X
KY43358207X00000X
CODR.0070287207X00000X
TXP7141207XX0005X
KS0450396207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810017020Medicaid
OH3041952Medicaid
KYP00852990OtherRR MEDICARE
KY7100109090Medicaid
WV3810017020Medicaid