Provider Demographics
NPI:1962552893
Name:KBB PODIATRIC CONSULTANTS INC
Entity type:Organization
Organization Name:KBB PODIATRIC CONSULTANTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-875-0443
Mailing Address - Street 1:1169 HILLTOP PKWY UNIT 101A
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-3173
Mailing Address - Country:US
Mailing Address - Phone:970-875-0443
Mailing Address - Fax:970-875-0446
Practice Address - Street 1:1169 HILLTOP PKWY UNIT 101A
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-3173
Practice Address - Country:US
Practice Address - Phone:970-875-0443
Practice Address - Fax:970-875-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64626539Medicaid
CO64626539Medicaid
COC447448Medicare PIN