Provider Demographics
NPI:1992863518
Name:ELMER, KATHLEEN BEVERLY (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:BEVERLY
Last Name:ELMER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8580 SCARBOROUGH DR STE 225
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7586
Mailing Address - Country:US
Mailing Address - Phone:719-531-5400
Mailing Address - Fax:719-531-9545
Practice Address - Street 1:1220 LAKE PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3548
Practice Address - Country:US
Practice Address - Phone:719-531-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR7724207N00000X
CODR.0071585207N00000X
WAMD60600179207N00000X
FLME58935207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology