Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 45574 | CO |
N | 207W00000X | Ophthalmologist | A90950 | CA |
NPI | 1023166345 |
---|---|
Provider Name | Arthur Korotkin |
First Address | Fort Collins, CO 80525-1307 |
Second Address | Fort Collins, CO 80525-1307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 03/12/2009 |