Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0056703 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | DR.0056703 | CO |
N | 207XX0801X | Orthopaedic Trauma Surgeon | DR.0056703 | CO |
N | 207XX0801X | Orthopaedic Trauma Surgeon | P8045 | TX |
NPI | 1023218880 |
---|---|
Provider Name | Augusta W Kluk |
First Address | Colorado Springs, CO 80910-3113 |
Second Address | Colorado Springs, CO 80918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 22/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
341859201 | (05) | TX |