Provider Demographics
NPI:1487762761
Name:COLUMBINE FOOT & ANKLE CENTER P C
Entity type:Organization
Organization Name:COLUMBINE FOOT & ANKLE CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:JELINEK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-499-4448
Mailing Address - Street 1:350 BROADWAY
Mailing Address - Street 2:STE 208
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:303-499-4448
Mailing Address - Fax:303-499-5123
Practice Address - Street 1:350 BROADWAY
Practice Address - Street 2:STE 208
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305
Practice Address - Country:US
Practice Address - Phone:303-499-4448
Practice Address - Fax:303-499-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01004654Medicaid
COBJ3531248OtherDEA
COCOA106366Medicare PIN
U39756Medicare UPIN
CO01004654Medicaid